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      Selective Alpha-1 Inhibitors: First-or Second-Line Antihypertensive Agents?

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          Abstract

          It is well documented that in the treatment of mild or moderate hypertension selective α<sub>1</sub>-inhibitors such as doxazosin and prazosin lower blood pressure to approximately the same extent as β-blockers, diuretics, ACE inhibitors and calcium antagonists. However, treatment with selective αi-inhibitors is also associated with a number of other favourable effects. For example, in contrast to most β-blockers, selective αi-inhibitors have a favourable effect on serum lipids, primarily lowering the triglycerides but also increasing the ratio of high-density lipoprotein (HDL) cholesterohtotal cholesterol. In addition, selective αi-inhibitors do not aggravate glucose metabolism or increase uric acid concentration, as thiazide diuretics frequently do. Some patients gain particular benefit from treatment with a selective α<sub>1</sub>-inhibitor, namely those with non-insulin-dependent diabetes mellitus, peripheral vascular disease, chronic obstructive pulmonary disease, and kidney failure. While no controlled mortality trials with selective α<sub>1</sub>-inhibitors have yet been completed, new vasodilator drugs such as these do lower blood pressure in a more physiological manner than traditional antihypertensive agents, and appear to cause fewer side effects. In this respect, with the exception of patients with manifest or strongly suspected coronary heart disease who are not receiving β-blocker treatment, selective α<sub>1</sub>-inhibitors should be recommended as first-line agents for the treatment of hypertension.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1993
          1993
          18 November 2008
          : 83
          : 3
          : 150-159
          Affiliations
          aDepartment of Heart Disease, Haukeland Hospital, Bergen, bThe Oslo Study, Ulleval Hospital, Oslo, cMedical Department, Haukeland Hospital, Bergen, dMedical Department B, Rikshospitalet (The National Hospital), Oslo, Norway
          Article
          175963 Cardiology 1993;83:150–159
          10.1159/000175963
          7904230
          © 1993 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 10
          Categories
          General Cardiology, Review

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