The place of alpha blockers in the antihypertensive armamentarium.

Although beta-blockers and diuretics are presently the only medications shown to reduce morbidity and mortality in hypertensives in large clinical trials, these drugs have not exerted optimal expected benefits in reducing cardiac events. Alpha-1 selective blockers exhibit a favorable impact on lipids, particularly on HDL-cholesterol. Unlike beta-blockers, they do not increase triglycerides and they do not produce the increase in LDL-cholesterol observed with traditional doses of diuretics. Alpha-blockers should be considered in the treatment of hypertensives with lipid disorders or diabetes and in those who have contraindications, failure to respond or toxicity associated with diuretics and/or beta-blockade.