Use of α blockers in Hypertension
α-Blockers block neuromuscular transmission by occupying the postsynaptic α1-adrenoceptor on the smooth muscle cell, causing vasodilation. Their major adverse effects are dizziness, headache, orthostatic hypotension (particularly first-dose hypotension), and an increased risk of falls and hip fractures). Since the early termination of the doxazosin arm of Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack trial (ALLHAT), resulting from a significantly increased risk of combined cardiovascular events (especially heart failure), α-blockers have been relegated to, at best, second-line therapy for uncomplicated hypertension; doxazosin was used successfully as the third therapy in ASCOT. α-Blockers are beneficial (in combination with other antihypertensive drugs) for men with symptoms of benign prostatic hyperplasia and have “favorable” effects on lipids and glucose metabolism.