^-Antagonists in the Treatment of Hypertension

A number of agents are now available to treat hypertension. One relatively new class of agents is the selective (^-inhibitors, which have distinct advantages over earlier nonselective aadrenergic receptor-blocking agents. Three ^-inhibitors are reviewed in this article: prazosin, terazosin, and doxazosin. These ^-inhibitors are similar in chemical structure and pharmacological action. or,-Inhibitors lower blood pressure by reducing vascular tone in resistance and capacitance vessels. ^-Inhibitors are similar in effectiveness in blood pressure lowering to other commonly used antihypertensive agents like the thiazide diuretic drugs and /3-blockers, which are efficacious as monotherapy in lowering pressure, as initial agents, or in combination with other antihypertensive agents in multidrug therapeutic regimens. ^-Inhibitors are associated with a reasonably low incidence of serious adverse effects and are essentially free of any adverse metabolic effects. ^-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. (Hypertension 1989;13(suppl I):I-131—1-136)