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Alpha1-adrenergic blockers: current usage considerations - PubMed

Review

Alpha1-adrenergic blockers: current usage considerations

Domenic A Sica. J Clin Hypertens (Greenwich). 2005 Dec.

Abstract

Alpha1-adrenergic-blocking drugs are effective in reducing blood pressure and do so in a fashion comparable to most other antihypertensive drug classes. These compounds are most effective in patients in the upright position, reducing systolic and diastolic pressures by 8%-10%. Alpha1-adrenergic-blocking drugs incrementally reduce blood pressure when combined with most drug classes and are the only antihypertensive drug class to improve plasma lipid profiles. Alpha1-adrenergic-blocking drugs are also accepted as important elements of the treatment plan for symptomatic benign prostatic hypertrophy. Dose escalation of an alpha1-adrenergic-blocking drug can trigger renal Na+ retention, and the ensuing volume expansion can attenuate its blood pressure-lowering effect. Orthostatic hypotension can occur with these compounds, particularly when a patient is volume-contracted. Dizziness, headache, and drowsiness are common side effects with alpha1-adrenergic blockers. A modest decline in the use of doxazosin and other alpha1-adrenergic-blocking drugs has occurred coincident to the early termination of the doxazosin treatment arm in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial.

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Figures

**Figure**
Trends in new α blocker and doxazosin prescriptions received by retail pharmacies. Data are from the National Prescription Audit Plus from IMS Health (Plymouth Meeting, PA) and are based on new prescriptions from January 1996 through December 2002. “ALLHAT Results” indicates the release date of findings from the Antihypertensive and Lipid‐Lowering Treatment to Prevent Heart Attach Trial. Reproduced with permission from JAMA. *2004;291:54–62.* ¹

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Alpha1-adrenergic blockers: current usage considerations - PubMed