Alpha Adrenergic Blockers in the Treatment of Hypertension--A Nephrologist's Perspective.

W know by now that hypertension is associated with considerable cardiovascular morbidity. that control of blood pressure offers freedom from many such complications is also proven. but a lot more remains to be known about the enigma named hypertension. We s t i l l do not know the exac t pathogenesis of hypertension; every s i n g l e a u t h o r d i f f e r s i n d e f i n i n g hypertension. little is known about the optimum goal of treatment. but maximum controversy centres on the choice of anti-hypertensive drug. With each new recommendation, some new group of drugs gets a nod while some drugs fall from the grace. in nephrology practice, while selecting the appropriate anti-hypertensive agent, the clinician has to keep in mind two aspects in addition to achieving the target blood pressure (bP). first ly, an agent should be chosen which is renoprotective. it will preserve renal function, thereby preventing or retarding the invariable downhill course of the disease. At the same time, it will not adversely affect the internal environment. hence an agent which may aggravate or precipitate hyperkalaemia is not particularly welcomed by the nephrology community. the group of drugs cal led alpha adrenergic blockers does not figure as the preferred agent in most of the recommendations of late.1