Time to re-appraise the role of alpha-1 adrenoceptor antagonists in the management of hypertension?

@article{Chapman2010TimeTR,
  title={Time to re-appraise the role of alpha-1 adrenoceptor antagonists in the management of hypertension?},
  author={Neil Chapman and Chung -Yin Chen and Toshiro Fujita and F. D. Richard Hobbs and Soo-Joong Kim and Jan A. Staessen and Supachai Tanomsup and Ji-Guang Wang and Bryan Williams},
  journal={Journal of Hypertension},
  year={2010},
  volume={28},
  pages={1796–1803}
}
The role of alpha-1 adrenoceptor antagonists (alpha-blockers) in the management of hypertension continues to evolve. Recent data support their use as add-on therapy in uncontrolled hypertension when used in combination with all other major classes of antihypertensive drug and there is increasing evidence suggesting that they have modest but significant beneficial effects on lipid and glucose metabolism. The availability of extended-release formulations has contributed to an excellent… 

Role of α1‐blockers in the current management of hypertension

Among the currently available agents, only long‐acting α1‐blockers, such as doxazosin gastrointestinal therapeutic system 4–8 mg daily and terazOSin 2–4 mg daily, should be chosen.

The Anglo-Scandinavian Cardiac Outcomes Trial: Implications and Further Outcomes

Preliminary discussions between United Kingdom and Swedish colleagues reviewed ongoing trials, including the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial, and focused on the design of a 2-way comparison trial comparing older treatment strategies with a newer treatment strategy based a calcium channel blocker and an angiotensin-converting enzyme inhibitor.

MH-76, a Novel Non-Quinazoline α1-Adrenoceptor Antagonist, but Not Prazosin Reduces Inflammation and Improves Insulin Signaling in Adipose Tissue of Fructose-Fed Rats

MH-76 may improve insulin signaling in adipose tissue by reducing the pro-inflammatory cytokine production and inhibiting the inflammatory cells recruitment and reducing insulin resistance and abdominal adiposity.

Lipid Effects of Antihypertensive Medications

Initial clinical trials of antihypertensive regimens suggested that blood pressure lowering was the most important aspect of therapy and that the adverse effects on lipids and glucose tolerance did not impact clinical outcomes, but newer trials question this finding and implicate these pleotropic effects as contributing to the results of the trials.

Evaluation of the Effects of Prazosin on Resistant Diastolic Hypertension With a Focus on Sex Difference

Low-dose prazosin as an additional drug to other major antihypertensive drugs with minor and transient complications can be reliably effective in reducing resistant DBP.

Alpha Adrenergic Blockers in the Treatment of Hypertension--A Nephrologist's Perspective.

  • A. Taraphder
  • Medicine
    The Journal of the Association of Physicians of India
  • 2014
In nephrology practice, while selecting the appropriate anti-hypertensive agent, the clinician has to keep in mind two aspects in addition to achieving the target blood pressure (bP): an agent should be chosen which is renoprotective and that which may aggravate or precipitate hyperkalaemia.

Vaccine Targeted Alpha 1D-Adrenergic Receptor for Hypertension.

The present results demonstrate that the ADRQβ-004 vaccine may provide a novel and promising method for the treatment of hypertension and downregulated the expression of α1D-AR, but not α1A-AR.

Resistant hypertension: what the cardiologist needs to know.

The aim of this review is to provide guidance for the cardiologist on how to identify patients with TRH and elucidate the prevailing underlying pathophysiological mechanism(s), to define a strategy for the identification of patients withTRH who may benefit from device-based interventions and discuss results and limitations of these interventions.

References

SHOWING 1-10 OF 59 REFERENCES

Alpha 1-blockade for the treatment of hypertension: a megastudy of terazosin in 2214 clinical practice settings.

Terazosin maintained its antihypertensive efficacy and was well tolerated by patients with a variety of concomitant diseases, including congestive heart failure, peripheral vascular disease, chronic obstructive pulmonary disease, benign prostatic hyperplasia, diabetes, and obesity.

Alpha 1-blockade for the treatment of hypertension: a megastudy of terazosin in 2214 clinical practice settings.

Terazosin maintained its antihypertensive efficacy and was well tolerated by patients with a variety of concomitant diseases, including congestive heart failure, peripheral vascular disease, chronic obstructive pulmonary disease, benign prostatic hyperplasia, diabetes, and obesity.

The diabetogenic potential of thiazide-type diuretic and beta-blocker combinations in patients with hypertension

The results suggest that the routine combined use of a thiazide with a beta-blocker should be questioned in the early management of hypertension, particularly in patients who are at increased risk of developing new-onset diabetes.

The treatment of mild hypertension study.

The Treatment of Mild Hypertension Study (TOMHS) represents a worthy contribution to the evaluation of therapeutic interventions on outcomes in patients with mild hypertension and the overall benefit of antihypertensive agents plus lifestyle modification compared with lifestyle modification alone.

Doxazosin versus bendrofluazide: a comparison of the metabolic effects in British South Asians with hypertension.

Doxazosin exhibits beneficial effects on glucose concentrations and lipid profile, in particular in lowering triglyceride concentrations in British South Asians, and whether these desirable characteristics translate to improved overall cardiovascular risk requires formal evaluation.

Effect of Doxazosin Gastrointestinal Therapeutic System as Third-Line Antihypertensive Therapy on Blood Pressure and Lipids in the Anglo-Scandinavian Cardiac Outcomes Trial

The present findings suggest that doxazosin is a safe and effective third-line antihypertensive agent, and α-Blockers are no longer recommended as add-on therapy in some hypertension guidelines.

Major cardiovascular events in hypertensive patients randomized to doxazosin vs chlorthalidone: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). ALLHAT Collaborative Research Group.

The data indicate that compared with doxazosin, chlorthalidone reduces the risk of combined CVD events, particularly CHD death/nonfatal MI, in high-risk hypertensive patients.

A 5-year comparison of doxazosin and atenolol in patients with mild-to-moderate hypertension: effects on blood pressure, serum lipids, and coronary heart disease risk.

Once-daily treatment with doxazosin produced a significantly greater beneficial effect on both 10-year CHD risk and serum lipid parameters compared with atenolol.

Administration-Time-Dependent Effects of Doxazosin GITS on Ambulatory Blood Pressure of Hypertensive Subjects

Bedtime dosing with doxazosin GITS significantly reduced blood pressure throughout the 24 h both when used as a monotherapy and when used in combination with other antihypertensive pharmacotherapy.
...