Pandit R B
Department of Cardiology, Dr Babasaheb Ambedkar Memorial Hospital, Bombay.
Indian Heart J. 1996 May-Jun;48(3):265-71.
With the inclusion of alpha-blockers in the list of drugs recommended as firstline agents for managing hypertension, there has been a resurgence of interest in this group of drugs. The selective alpha-1 blockers reduce peripheral vascular resistance by blocking the alpha-1 receptors and preventing norepinephrine from reaching them. Their antihypertensive efficacy has been shown to be comparable to all other major classes of antihypertensive agents. They are also as well tolerated as the other currently used drugs, both facts being confirmed by the TOMHS. What differentiates them from the rest of the drugs is their beneficial effects on various other coronary heart disease (CHD) risk factors. While lowering blood pressure (a CHD risk factor by itself), the selective alpha-1 blockers also reduce serum total cholesterol and increase serum HDL cholesterol (yet another major CHD risk factor). These drugs have been shown to increase insulin sensitivity and lower blood glucose levels. In addition, they also cause regression of left ventricular hypertrophy. Given these added beneficial effects, the lipid- and glucose-friendly selective alpha-1 blockers are increasingly being used.
随着α受体阻滞剂被列入推荐作为治疗高血压一线药物的清单中，人们对这类药物的兴趣再度兴起。选择性α1受体阻滞剂通过阻断α1受体并阻止去甲肾上腺素作用于它们来降低外周血管阻力。它们的降压效果已被证明与所有其他主要类别的抗高血压药物相当。它们的耐受性也与目前使用的其他药物相同，这两个事实均得到了抗高血压和降脂治疗预防心脏病发作试验（TOMHS）的证实。它们与其他药物的不同之处在于它们对各种其他冠心病（CHD）危险因素具有有益作用。在降低血压（本身就是冠心病的一个危险因素）的同时，选择性α1受体阻滞剂还能降低血清总胆固醇并提高血清高密度脂蛋白胆固醇（这是另一个主要的冠心病危险因素）。这些药物已被证明能提高胰岛素敏感性并降低血糖水平。此外，它们还能使左心室肥厚消退。鉴于这些额外的有益作用，对脂质和血糖友好的选择性α1受体阻滞剂的使用越来越多。
