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Primary outcomes were scores on the Penn Alcohol Craving Scale (PACS), standard drink units (SDUs) per day averaged over each week, % days of any drinking per week, and % days of heavy drinking per week.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>\n<jats:styled-content style=\"fixed-case\">PACS<\/jats:styled-content> declines did not differ significantly between the prazosin and placebo groups in the overall sample. In the subgroup with comorbid <jats:styled-content style=\"fixed-case\">PTSD<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u200948), <jats:styled-content style=\"fixed-case\">PACS<\/jats:styled-content> declines were significantly greater in the prazosin than in the placebo condition (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.05)<jats:italic>.<\/jats:italic> Baseline alcohol consumption was markedly reduced by the pre\u2010randomization outpatient alcohol treatment program, but the addition of prazosin treatment produced a greater slope of decline in <jats:styled-content style=\"fixed-case\">SDUs<\/jats:styled-content> per day compared to placebo (<jats:italic>p<\/jats:italic>\u00a0=\u20090.01). Preplanned subgroup analyses were performed in soldiers with elevated baseline cardiovascular measures consistent with increased noradrenergic signaling. In soldiers with elevated standing heart rate (<jats:italic>n<\/jats:italic>\u00a0=\u200915), prazosin reduced <jats:styled-content style=\"fixed-case\">SDUs<\/jats:styled-content> per day (<jats:italic>p<\/jats:italic>\u00a0=\u20090.01), % days drinking (<jats:italic>p<\/jats:italic>\u00a0=\u20090.03), and % days heavy drinking (<jats:italic>p<\/jats:italic>\u00a0=\u20090.001) relative to placebo. In soldiers with elevated standing systolic blood pressure (<jats:italic>n<\/jats:italic>\u00a0=\u200927), prazosin reduced <jats:styled-content style=\"fixed-case\">SDUs<\/jats:styled-content> per day (<jats:italic>p<\/jats:italic>\u00a0=\u20090.04) and tended to reduce % days drinking (<jats:italic>p<\/jats:italic>\u00a0=\u20090.056). Prazosin also reduced depressive symptoms and the incidence of emergent depressed mood more than placebo (<jats:italic>p<\/jats:italic>\u00a0=\u20090.05 and <jats:italic>p<\/jats:italic>\u00a0=\u20090.01, respectively). During the final 4\u2009weeks of prazosin vs. placebo treatment that followed completion of Army outpatient <jats:styled-content style=\"fixed-case\">AUD<\/jats:styled-content> treatment, alcohol consumption in soldiers with elevated baseline cardiovascular measures increased in those receiving placebo but remained suppressed in those receiving prazosin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These results extend reports that higher pretreatment cardiovascular measures predict <jats:italic>beneficial<\/jats:italic> effects of prazosin, which may be useful for relapse prevention in patients with AUD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.14989","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T18:25:37Z","timestamp":1677003937000},"page":"348-360","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["A randomized controlled clinical trial of 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