Abstract: Objective To evaluate whether the alpha-1 adrenoceptor blocker, urapidil, provides additional therapeutic benefits compared to nitroglycerin in treatment of non valvular heart failure complicated with hypertension and diabetes mellitus (DM) in elderly patients.Methods Eighty-two elderly patients with non valvular heart failure complicated with hypertension and diabetes mellitus were randomized into two groups who received either urapidil or nitroglycerin, respectively. All patients were monitored for blood pressure (BP), heart rate (HR), and received tests for metabolic activity and cardiovascular function prior to and after treatment. Results Patients receiving urapidil had significantly lower systolic blood pressure (SBP) than their counterparts in nitroglycerin group. Moreover, patients in urapidil group showed lower N-terminal B type natriuretic peptide (NT-proBNP) levels compared to patients in nitroglycerin group. While both urapidil and nitroglycerin decreased fasting plasma glucose (FPG) levels, there was no significant difference in FPG levels between these two groups.Conclusion Urapidil demonstrated better efficacy than nitroglycerin on lowering and stabilizing SBP, attenuating cardiac afterload, and improving cardiac function. Urapidil is a therapeutic option for the elderly patients complicated with hypertension and DM.

Key words: urapidil, hypertension, diabetes mellitus, elderly patients, heart failure