Authors: Jan Buch
Publish Date: 2010/06/28
Volume: 27, Issue: 7, Pages: 426-443
Abstract
Despite the availability of a wide range of effective blood pressure BPlowering agents a substantial proportion of patients with hypertension fail to achieve target BP levels The majority of patients with hypertension need a combination of two or more drugs to achieve BP targets and choice of secondline or subsequentline therapy is an important consideration in hypertension management Alpha1adrenoreceptor antagonists alphablockers have a BPlowering effect broadly similar to the other antihypertensive drug classes and are effective as addon therapy in patients with inadequately controlled hypertension Alphablockers may also have therapeutic benefits that go beyond BP control including improvements in lipid profile and glucose metabolism as well as reducing the symptoms of benign prostatic hyperplasia Urapidil has an alphablocking effect but unlike other alphablockers also has a central sympatholytic effect mediated via stimulation of serotonin 5HT1A receptors in the central nervous system Several studies have suggested that oral urapidil is effective and well tolerated when used as secondline therapy in patients with BP inadequately controlled with other agents Urapidil has also been shown to improve glucose and lipid metabolism in hypertensive patients with concomitant diabetes and/or hyperlipidemia Intravenous urapidil is effective in the treatment of hypertensive crises perioperative hypertension and preeclampsia and may have a potential role in the management of acute stroke In this review the use of alphablockers in hypertension is discussed with particular focus on urapidil for the lowering of BP in a variety of clinical settings
Keywords: