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Other conventional antihypertensive drugs which are being currently used are alpha-adrenoreceptor antagonists, centrally acting agents (stimulate alpha-2-receptors and/or imidazoline receptors in medulla) and vasodilators (relax vascular smooth muscle). Most of the above drugs are used as an add on therapy or have special indications such as alpha-blockers in proven phaeochromocytoma. Involvement of reninangiotensinaldosterone system, endothelins, vasopeptidases, and Rho-kinase in the pathophysiology of hypertension has led to the discovery of novel antihypertensive drugs which possess either inhibitory or blocking action on one of the above mechanisms. Preliminary data with renin inhibitors look very promising as they have been shown to reduce filtration fraction and proteinuria and also improve heart failure in even those cases where angiotensin-converting enzyme inhibitors proved ineffective. Eplerenone, a selective aldosterone antagonist, has been shown to have mortality-reducing action in hypertensive patients with heart failure following myocardial infarction.
Chapter. 1981 words.
Subjects: Cardiovascular Medicine
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