Cardiovascular effects of antihypertensive drugs — Involvement in the therapeutic choice

Essential Hypertension: Evaluation and Treatment

“…Alpha-adrenergic blockers exhibit no negative effects on lipoproteins, glucose metabolism, or sexual function (Tuck, 1990). Total cholesterol and low-density lipoprotein decrease about 4%, whereas high-density lipoprotein increases about 8% (Horan, 1991;Luque-Otero & Fernandez-Pinilla, 1990).…”

“…Diastolic performance improves after treatment of even mild hypertension and reduces cardiovascular, cerebral, and renal complications by 19% to 35%. Alpha-adrenergic blockers, angiotensin-converting enzyme inhibitors, and calcium channel blockers reduce afterload, improve systemic blood flow, and improve perfusion of target organs (Lewis, Hunsicker, Bain, & Rohde, 1993;Rocella Bc Bowler, 1990;Winterkorn, Kupersmith, Wirtschafter, & Forman, 1993), Afierload reduction improves functional capacity of large arteries, presumably by augmenting coronary artery filling, myocardial performance, and vascular wall integrity (Luque-Otero & Fernandez-Pinilla, 1990 (Pfeffer & Pfeffer, 1990). Cardiovascular assessment will determine the choice of peripheral vasodilating drug for each patient.…”

“…After acute dosing, prazosin peak effect occurs at 1 to 3 hours, due to its short half-life of 2 to 3 hours, whereas doxazosin provides the longest half-life (22 hours) with peak effect as late as 6 hours. Pinilla, 1990;Oren, Messerli, Grossman, Garavaglia, & Frohlich, 1991). ACE inhibitors inhibit vascular angiotensin-I1 formation systemically and peripherally.…”

“…Diuretics deplete intravascular volume, drop cardiac output, and increase total systemic peripheral vascular resistance (Luque-Otero & Fernandez-Pinilla, 1990). Diuretics worsen tissue resistance to insulin (Swislocki, Hoffman, & Reaven, 1989;Tuck, 1990).…”

“…Beta blockers produce negative chronotropic and negative inotropic cardiac effects. Beta blockers increase afterload and systemic vascular resistance while decreasing cardiac output (Luque-Otero & Fernandez- Pinilla, 1990;Messerli, 1990a;Zusman et al, 1989).…”