Vasodilator therapy of heart failure. Has the promissory note been paid?

IN 1977 Miller et al. reported in the Journal that a single oral dose of prazosin could improve the altered hemodynamics of heart failure.1 Among the desirable characteristics of this alpha-1-adrenergic blocking agent are its actions on both the arteriolar and venous beds and its lack of serious adverse effects. In an accompanying editorial, a classification of the vasodilators that were available into those that act primarily on the arteriolar bed (afterload-reducing agents), on the venous bed (preload-reducing agents), and on both the arteriolar and venous beds (balanced vasodilators) was offered, and it was suggested that "vasodilator therapy is emerging . . .

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