Hemodynamic effects of antihypertensive drugs.

Elevated total peripheral resistance and normal cardiac output are the hemodynamic characteristics of chronic essential hypertension. One approach to treating hypertension matches the individual pathophysiology with the hemodynamic effects of antihypertensive drugs. Antiadrenergic drugs are appropriate second-step therapy in many cases of established hypertension; by reducing total peripheral resistance, these agents can reduce blood pressure while sparing cardiac output and renal blood flow. The physician should treat elderly hypertensive patients cautiously and consider using drug with a favorable hemodynamic profile.