Peripheral Alpha Blockers

Orit Barrett, Talya Wolak

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

Abstract

From the mid-1970s until the beginning of the current century (2000), alpha1-adrenergic receptor (α1-AR) blockers were widely used and considered safe and effective antihypertensive medications. In 2000, the landmark Antihypertensive and Lipid-Lowering [to prevent] Heart Attack Trial (ALLHAT trial) was published, which demonstrated greater incidence of combined cardiovascular diseases, especially heart failure, in patients assigned to the α1-AR blocker, doxazosin, arm. Since this publication, the usage of α1-AR blocker as antihypertensive medication declined dramatically due to cardiac safety concern. Currently, latest clinical guidelines place α1-AR blocker not in the first line of hypertension treatment, but as part of a multiple-drug combination, saved for patients with resistant hypertension. After the ALLHAT trial publication, several large-scale studies were conducted using α1-AR blockers as part of a drug regimen to achieve the desired blood pressure target. These studies showed that the effective blood pressure reduction achieved by α1-AR blockers was not associated with increased cardiac morbidity. Considering current guidelines and results from recent studies, α1-AR blockers can be used as third or fourth medication in patients who did not achieve blood pressure control under treatment with angiotensin converting enzyme (ACE-I)/angiotensin receptor blockers (ARB), calcium channel blockers, and diuretics.

Original languageEnglish
Title of host publicationHypertension
Subtitle of host publicationA Companion to Braunwald's Heart Disease
PublisherElsevier
Pages297-303
Number of pages7
ISBN (Electronic)9780323883696
ISBN (Print)9780323931731
DOIs
StatePublished - 1 Jan 2023
Externally publishedYes

Keywords

  • ALLHAT
  • alpha adrenergic receptors
  • alpha blocker
  • sympathetic nervous system

ASJC Scopus subject areas

  • General Medicine

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