What is the role of alpha-blocker based regimens in the control of blood pressure ? The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack (ALLHAT) trial showed that an alpha-blocker based regimen is less efi'ective than a diuretic-based regimen in preventing heart failure (JAMA 2000: 283: 1967-75). Additionally, there was a marginally significant excess of stroke in the alpha-blocker group. Although poorer blood pressure control might account for the higher risk of stroke, it does not entirely explain the two-fold greater risk of heart failure.
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