Centrally acting antihypertensive agents: an update.

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Sica DA

Centrally acting antihypertensive agents: an update.

J Clin Hypertens (Greenwich). 2007 May;9(5):399-405.

PubMed ID

17485976 [ View in PubMed

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Abstract

Centrally acting agents stimulate alpha(2) receptors and/or imadozoline receptors on adrenergic neurons situated within the rostral ventrolateral medulla and, in so doing, sympathetic outflow is reduced. Centrally acting agents also stimulate peripheral alpha(2) receptors, which, for the most part, is of marginal clinical significance. Central a agonists have had a lengthy history of use, starting with alpha-methyldopa, which has had a dramatic decline in use, in part, because of bothersome side effects. Patients who require multidrug therapy with otherwise resistant hypertension, such as diabetic and/or renal failure patients, are typically responsive to these drugs, as are patients with sympathetically driven forms of hypertension. Perioperative forms of hypertension respond well to clonidine, a circumstance where the additional anesthesia- and analgesia-sparing effects of this drug may offer additional clinical benefits. Clonidine can be used adjunctively with other more traditional therapies in heart failure, particularly when hypertension is present. Sustained-release moxonidine, however, is associated with early mortality and morbidity when used in patients with heart failure. Escalating doses of drugs in this class often give rise to salt and water retention, in which case diuretic therapy becomes a valuable adjunctive therapy.

DrugBank Data that Cites this Article

Drugs

Methyldopa

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Methyldopa	Alpha-2A adrenergic receptor	Protein	Humans	Yes	Agonist	Details