Abstract:
There is emerging evidence that α1-blockers can be safely used in the treatment of hypertension. These drugs can be used in almost all hypertensive patients for blood pressure control. However, there are several special indications. Benign prostatic hyperplasia is a compelling indication of α1-blockers, because of the dual treatment effect on both high blood pressure and lower urinary tract symptoms. Many patients with resistant hypertension would require α1-blockers as add-on therapy. Primary aldosteronism screen is a rapidly increasing clinical demand in the management of hypertension, where α1-blockers are useful for blood pressure control in the preparation for the measurement of plasma aldosterone and renin. Nonetheless, α1-blockers have to be used under several considerations. 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. Orthostatic hypotension is a concern with the use of α1-blockers especially in the elderly, and requires careful initial bedtime dosing and avoiding overdosing. Fluid retention is potentially also a concern, which may be overcome by combining an α1-blocker with a diuretic.
摘要:
有新的证据表明α1-受体阻滞剂可以安全地用于治疗高血压。这些药物可用于几乎所有高血压患者的血压控制。然而,有几个特殊的迹象。良性前列腺增生是α1受体阻滞剂的令人信服的适应症,因为对高血压和下尿路症状的双重治疗效果。许多顽固性高血压患者需要α1-受体阻滞剂作为附加疗法。原发性醛固酮增多症筛查是高血压管理中快速增长的临床需求,其中α1-受体阻滞剂可用于控制血压,以准备测量血浆醛固酮和肾素。尽管如此,α1-阻断剂必须在几个考虑下使用。在当前可用的代理商中,只有长效α1受体阻滞剂,如多沙唑嗪胃肠治疗系统4-8毫克,每日和特拉唑嗪2-4毫克,应该选择。体位性低血压是使用α1受体阻滞剂的一个问题,特别是在老年人中,并且需要小心的初始睡前给药并避免过量给药。液体滞留也可能是一个问题,可以通过将α1受体阻滞剂与利尿剂结合使用来克服。