α1-Antagonists in the treatment of hypertension

Abstract

A number of agents are now available to treat hypertension. One relatively new class of agents is the selective (α1-inhibitors, which have distinct advantages over earlier nonselective aadrenergic receptor-blocking agents. Three α1-inhibitors are reviewed in this article: prazosin, terazosin, and doxazosin. These α1-inhibitors are similar in chemical structure and pharmacological action. or,-Inhibitors lower blood pressure by reducing vascular tone in resistance and capacitance vessels. α1-Inhibitors are similar in effectiveness in blood pressure lowering to other commonly used antihypertensive agents like the thiazide diuretic drugs and β-blockers, which are efficacious as monotherapy in lowering pressure, as initial agents, or in combination with other antihypertensive agents in multidrug therapeutic regimens. α-Inhibitors are associated with a reasonably low incidence of serious adverse effects and are essentially free of any adverse metabolic effects. α1-Inhibitors have been shown to beneficially effect blood lipids in several studies. The favorable lipid effect makes ^-inhibitors especially appropriate to use in diabetic hypertensive and other patients with elevated serum lipid levels. The beneficial lipid effects may enhance the ability of ar,-inhibitors to prevent coronary heart disease, an outcome that has been difficult to demonstrate in thiazide-based trials. © 1989 American Heart Association, Inc.