Martini Ziekenhuis, afd. Interne Geneeskunde, Postbus 30.033, 9700 RM Groningen. k.hoogenberg@mzh.nl
A number of Dutch medical journals have carried an advertisement promoting doxazosin in the treatment of hypertension in patients with type 2 diabetes mellitus. No long-term randomised clinical trials have examined the cardiovascular outcomes of the alpha-adrenergic blockers to which doxazosin belongs. The drug was removed from the largest study into blood pressure and cholesterol reduction ever performed until now (the antihypertensive and lipid-lowering treatment to prevent heart attack trial), due to an increased incidence of cardiovascular events and in particular congestive heart failure. The clinical significance of its insulin-sensitivity improving and lipid-neutralising effects in small-scale, short-term, small patient-group studies are ambiguous. Accordingly, national and international guidelines omitted the drug in their treatment recommendations. The advertisement claims are therefore misleading.