From the Guidelines
Yes, doxazosin, an alpha-1 adrenergic receptor blocker, can cause atrial fibrillation.
Evidence Summary
- The 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1 suggests that antihypertensive therapy with doxazosin is associated with a higher occurrence of atrial fibrillation (AF) or atrial flutter compared to chlorthalidone.
- The study found that the occurrence of AF or atrial flutter during the study was associated with an increase in mortality of nearly 2.5-fold, highlighting the potential risks of doxazosin in relation to atrial fibrillation.
- It is essential to consider these findings when prescribing doxazosin, particularly in patients with a history of cardiovascular disease or those at high risk of developing atrial fibrillation.
Clinical Implications
- Clinicians should be aware of the potential risk of atrial fibrillation associated with doxazosin and closely monitor patients for signs and symptoms of AF, particularly during the initiation of therapy.
- The use of doxazosin should be carefully weighed against its potential benefits and risks, and alternative antihypertensive agents should be considered in patients at high risk of developing atrial fibrillation.
From the Research
Doxazosin and Atrial Fibrillation
- There is evidence to suggest that doxazosin, an alpha-1 adrenergic receptor blocker, may be associated with an increased risk of atrial fibrillation 2.
- A study published in the Journal of the American College of Cardiology found that new-onset atrial fibrillation or atrial flutter was associated with the same baseline risk factors as doxazosin treatment, but the incidence of atrial fibrillation did not differ by antihypertensive treatment group, excluding doxazosin 2.
- Another study published in the American Journal of Kidney Diseases found that alpha-blocker use, including doxazosin, was associated with a lower risk of cardiac events, including atrial fibrillation, in patients with chronic kidney disease 3.
- However, the evidence is not consistent, and more research is needed to fully understand the relationship between doxazosin and atrial fibrillation.
Mechanism of Action
- Doxazosin works by blocking alpha-1 adrenergic receptors, which can lead to a decrease in blood pressure and an increase in heart rate 4.
- The effects of doxazosin on the heart and blood vessels may contribute to an increased risk of atrial fibrillation, but the exact mechanism is not fully understood.
Clinical Implications
- Patients taking doxazosin should be monitored for signs and symptoms of atrial fibrillation, such as palpitations, shortness of breath, and fatigue 2.
- The benefits and risks of doxazosin treatment should be carefully weighed, particularly in patients with a history of heart disease or atrial fibrillation 3.