Side effects of sympatholytic antihypertensive drugs.

Engelman, Karl

doi:10.1161/01.hyp.11.3_pt_2.ii30

Cited by 11 publications

(4 citation statements)

References 13 publications

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“…Because of symptomatic side effects, the use of clonidine has been limited. The sexual problems of clonidine, especially in men, are also prominent [ 30 ]. But in some area of China, its compound preparation is also been used because of its cheap price and antihypertensive efficacy.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Treatment of Clonidine, Atenolol, Amlodipine and Dihydrochlorothiazide, but Not Enalapril, Impairs the Sexual Function in Male Spontaneously Hypertensive Rats

Lin

Wang

et al. 2015

PLoS ONE

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This study was designed to investigate the impact of representative antihypertensive drugs of 5 classes on the sexual function in male spontaneously hypertensive rats (SHR) at doses that achieved similar blood pressure (BP) reduction. The experiment was performed in 6 groups of male SHR. The dose are 20 μg/kg/day for clonidine, 3 mg/kg/day for enalapril, 20 mg/kg/day for atenolol, 2 mg/kg/day for amlodipine, and 10 mg/kg/day for dihydrochlorothiazide. SHR were treated for 3 months, and then the penile erection and sexual behavior were detected. After BP recording, SHR were killed to evaluate the organ-damage, weight of accessory sex organs and levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone in serum. Five drugs had the similar efficacy on BP reduction. All drugs except of enalapril, significantly prolonged the mount latency, and decreased the mount frequency (P<0.05). Clonidine also reduced the conception rate (45% vs. 80% in control group, P<0.05). Amlodipine and dihydrochlorothiazide significantly increased the testosterone level (0.79±0.30, 0.80±0.34 vs. 0.49±0.20 in control group, unit: ng/dl, P<0.05). Enalapril, atenolol and amlodipine also significantly decreased the BP variability (systolic, 8.2±2.5, 7.6±1.8, 8.9±2.0 vs. 12.2±3.8 in control group, unit: mm Hg). All these drugs significantly decreased the organ-damage (P<0.05). In conclusion, long-term treatment with 5 common antihypertensive drugs possessed obvious organ protection in SHR. Clonidine, atenolol, amlodipine and dihydrochlorothiazide, but not enalapril, impair sexual function.

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Section: Discussionmentioning

confidence: 99%

Long-Term Treatment of Clonidine, Atenolol, Amlodipine and Dihydrochlorothiazide, but Not Enalapril, Impairs the Sexual Function in Male Spontaneously Hypertensive Rats

Lin

Wang

et al. 2015

PLoS ONE

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“…Central α2-agonists act on the α2 presynaptic receptors in the brainstem: they determine inhibition of sympathetic tone and reduction of vasopressor efferent impulses from the centers of the brainstem, determining orthostatic hypotension mediated by vasodilatation [87]. There are no studies in literature which evaluate the prevalence of orthostatic hypotension in hypertensive subjects treated with this class of drugs.…”

Section: α-Blockersmentioning

confidence: 99%

Drugs and Orthostatic Hypotension: Evidence from Literature

Milazzo¹,

Stefano²,

Servo³

et al. 2012

J Hypertens Open Access

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disease (PD): its prevalence ranges between 14% and 80% [12]. It is related to older age, severity and duration of the disease [13,14] and can be caused by autonomic dysfunction, drugs, or both causes. Few studies have evaluated the specific mechanisms of orthostatic hypotension in patients with PD. Lowering of blood pressure may be mainly due to drugs (in particular levodopa), when autonomic cardiovascular function tests are normal [15]. On the other hand, the absence of activation of compensatory chronotropic mechanisms to low blood pressure while standing may be due to autonomic failure [16]. Dopaminergic agonists (levodopa, carbidopa) frequently cause orthostatic hypotension, even at the beginning of therapy, through the activation of dopamine receptors, determining cutaneous, mesenteric and renal vasodilation, but also through other mechanisms, such as a reduced central sympathetic tone, which causes a small reduction in heart rate, and an impaired release of renin and aldosterone [17,18]. However, among antiparkinsonian drugs, selegiline seems to be more frequently involved in the onset of orthostatic hypotension, even after long-term therapy, if compared to levodopa [16,19]. Furthermore, while combined treatment with both drugs can determine severe orthostatic hypotension [20,21], levodopa alone is less often responsible for this phenomen. In fact, in additon to the peripheral vasodilatation due to dopamine agonists, the decreased reuptake of dopamine and norepinephrine in central neurvous system caused by selegiline causes a reduction in sympathetic tone [22]. Ha et al. [13] did not find a significant difference in dopaminergic agonist doses between PD patients with and without symptoms related to orthostatic hypotension, suggesting that other factors, such as age and other concomitant therapies, may be responsible for orthostatic hypotension in PD [13]. These data were further confirmed by Perez-Lloret et al.

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“…Indeed all drugs that lower blood pressure by central adrenergic inhibition tend to produce sedation, fatigue and depression. Consequently, and despite some contrary evidence mentioned above, a past psychiatric history of depression would be regarded as a contraindication to their long term use (Engelman 1988).…”

Section: Other Antihypertensive Agentsmentioning

confidence: 96%

The Effect of Antihypertensive Treatment on the Quality of Later Years

Metcalfe

Potter

1993

Drugs & Aging

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There is now a considerable body of evidence demonstrating the benefit of pharmacological therapy in reducing cardiovascular risk in elderly hypertensive patients. With the high prevalence of hypertension that exists in the elderly, the impact of the widespread use of antihypertensive treatment on the quality of life of older individuals requires consideration. Quality of life is a difficult concept to define and thus to measure scientifically. It is most commonly measured in clinical trials using questionnaire-based instruments designed to assess the subjects' perception of their own health and the degree of well-being and satisfaction in various health-related areas of their lives. Nonpharmacological methods of blood pressure reduction are generally regarded as being neutral or beneficial in their effects on quality of life, and deserve prolonged evaluation in elderly patients before introducing pharmacological therapy. The many antihypertensive drug treatments now available have varying impact on quality of life, which should be taken into account when developing a rational approach to antihypertensive intervention in the elderly patient.

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Side effects of sympatholytic antihypertensive drugs.

Cited by 11 publications

References 13 publications

Long-Term Treatment of Clonidine, Atenolol, Amlodipine and Dihydrochlorothiazide, but Not Enalapril, Impairs the Sexual Function in Male Spontaneously Hypertensive Rats

Long-Term Treatment of Clonidine, Atenolol, Amlodipine and Dihydrochlorothiazide, but Not Enalapril, Impairs the Sexual Function in Male Spontaneously Hypertensive Rats

Drugs and Orthostatic Hypotension: Evidence from Literature

The Effect of Antihypertensive Treatment on the Quality of Later Years

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