Rational pharmacotherapy of hypertension. Urapidil potential

Abstract

Optimizing pharmacotherapy of arterial hypertension (AH) and varied selection of medicines remains an urgent problem for practitioners. However, despite the large variety of effective antihypertensive drugs, the control of blood pressure levels remains inadequate. Most patients require combined therapy with two or more agents to achieve target blood pressure levels, so the choice of second-line therapy is of particular importance. As adjunctive therapy in patients with uncontrolled hypertension a-blockerscan be used, which, in addition to the antihypertensive effect, have a number of other benefits including improved lipid profile and glucose metabolism, as well as reducing the symptoms of benign prostatic hyperplasia. Urapidil provides a-blocking effect and additionally exhibits the central sympatholytic effect which is mediated by stimulation of serotonin 5HT1A-receptor in the central nervous system. The evidence base suggests that the drug has antihypertensive effect in combination with a favorable metabolic profile, and has a good safety profile as well, and has no disadvantages inherent to a-blockers, in particular, the development of reflex tachycardia.

Keywords

• arterial hypertension
• pharmacotherapy
• antihypertensive therapy
• combined therapy
• a1-blockers
• urapidil
• ebrantil