Antihypertensive Therapy in the Geriatric Patient: II. A Review of the Alpha₁‐Adrenergic Blocking Agents

Abstract

The prevalence of hypertension increases with age. Multiple physiologic factors are involved in the development of hypertension in the elderly. Alpha1-adrenergic blocking agents lower blood pressure through a reduction in total peripheral resistance. Prazosin, terazosin, and doxazosin have been shown to be equally effective in reducing blood pressure in older persons. The bioavailability, terminal elimination half-life, and volume of distribution of prazosin is increased in the elderly. Hybrid drugs, such as ketanserin, urapidil, and indoramin are also effective in lowering blood pressure. Ketanserin seems to have a greater effect on blood pressure reduction in persons older than 60 years of age. Alpha1-adrenergic blockers may be used safely in patients with diabetes, asthma, and hyperlipidemia.

Treatment of benign prostatic hyperplasia and hypertension in elderly hypertensive patients

“…The major reason that Japanese physicians are reluctant to use α‐blockers in elderly patients is their side‐effect profile. In contrast, some studies have shown that α‐blockers appear to be effective as first‐line agents in the elderly [ 19 –21]. In addition, they have several advantages over other antihypertensive agents.…”

“…The incidence of vertigo with doxazosin treatment recorded the exception of postural hypotension, a-blockers have in a post-marketing survey conducted in Japan[19].…”

Eye and heart morphogenesis are dependent on the melatonin signaling in chick embryos

“…Prazosin is an α1-adrenergic receptor antagonist (Studer and Piepho, 1993), an NRH:quinone reductase antagonist (Pegan et al, 2011) and a Mel1c melatonin receptor antagonist (Chen et al, 2016). In this study, prazosin (0.1 µmol l −1 to 1 mmol l −1 ) was used to assess the activity of the Mel1c melatonin receptor in developing chick embryos.…”

Drug-Induced Orthostatic Hypotension in Older Patients

“…Bioavailability and distribution volume are increased. [51] The sensitivity to the product is conserved in elderly people. (52) As with other <XI-receptor blockers, orthostatic hypotension has been described, mainly due to impaired baroreflex activity.…”