Alpha blockers have modest efficacy in hypertension

January 01, 0001

Alpha blockers have modest efficacy in hypertension

Clinical Question:How effective are alpha blockers in the treatment of primary hypertension?

Bottom line: Based on the limited number of published randomised controlled trials, the blood pressure (BP) lowering effect of alpha blockers is modest (-8/-5 mmHg), compared to placebo. A dose response relationship for the BP lowering effect of alpha blockers could not be established. There were no clinically meaningful differences in BP lowering between 4 different alpha blockers (bunazosin, doxazosin, prazosin and terazosin). The review did not provide a good estimate of the incidence of harms associated with alpha blockers because of the short duration of the trials and the lack of reporting of adverse effects in many of the trials.

Caveat: Given the high likelihood of publication bias, the estimates of BP lowering effect calculated are likely to be an overestimate of the real effect. The effect of alpha blockers on BP variability, pulse pressure, or heart rate could not be determined.

Context: Alpha blockers are used as pharmacological agents for the treatment of hypertension. Despite nearly 30 years of research evidence and clinical use of alpha blockers, the dose-related BP lowering effect of this antihypertensive drug class is still not known.

Cochrane Systematic Review: Alpha blockers are used as pharmacological agents for the treatment of hypertension. Despite nearly 30 years of research evidence and clinical use of alpha blockers, the dose-related BP lowering effect of this antihypertensive drug class is still not known.

Cochrane PEARLS Practical Evidence About Real Life Situations. No. 223, December 2009.
Written by Brian R McAvoy. Published by the Cochrane Primary Care Group

Category: K. Circulatory. Keywords: hypertension, alpha blockers, bunazosin, doxazosin, prazosin, terazosin

Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 25 May 2010

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.