• Wei Yang, Yu-Jie Zhou, Yan Fu, Jian Qin, Shu Qin, Xiao-Min Chen, Jin-Cheng Guo, and Qi Hua.
• Department of Cardiology (WY, JQ, QH), Xuan Wu Hospital, Capital Medical University, Beijing, China; Department of Cardiology (Y-JZ), An Zhen Hospital Affiliated with Capital Medical University, Beijing, China; Department of Emergency (YF), Tong Ren Hospital Affiliated with Capital Medical University, Beijing, China; Department of Cardiology (ST), First Hospital Affiliated with Chongqing University, Chongqing, China; Department of Cardiology (X-MC), Ningbo First Hospital, Ningbo, China; and Department of Cardiology (J-CG), Luhe Hospital of Beijing Tongzhou District, Beijing, China.
• Am. J. Med. Sci. 2015 Aug 1; 350 (2): 109-15.

BackgroundMultifactor heart failure is a common life-threatening event in elderly patients and often complicated by concomitant hypertension and diabetes mellitus (DM). The aim of this study was to evaluate whether α1-blocker, urapidil, provides additional therapeutic benefits compared to nitroglycerin (NG) in treatment of multifactor heart failure complicated by hypertension and DM in elderly patients.MethodsSeventy-two elderly consecutive patients were randomized into 2 groups that received treatment with urapidil or NG. All patients were monitored for blood pressure (BP) and heart rate and received tests for metabolic activity and cardiovascular function.ResultsPatients receiving urapidil had significantly lower systolic BP than their counterparts in NG group (P < 0.05). Moreover, patients in urapidil group showed lower N-terminal pro-B-type natriuretic peptide levels but higher ejection fraction (t = 2.206, P < 0.05), cardiac index (t = 3.13, P < 0.05) and left end-diastolic volume (t = -3.104, P < 0.05) compared to NG group. Although both urapidil and NG decreased fasting plasma glucose (FPG) levels, there was no significant difference of FPG levels between these 2 groups.ConclusionsUrapidil demonstrated better efficacy than NG on lowering and stabilizing systolic BP, attenuating cardiac afterload and improving cardiac function. Both NG and urapidil significantly reduced FPG levels in multifactor heart failure patients with DM. Urapidil is a therapeutic option for the multifactor heart failure patients complicated with hypertension and DM.

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