Terazosin: a new antihypertensive agent with favorable effects on lipids

Terazosin is a new, selective, alpha 1-adrenoceptor antagonist which is structurally similar to prazosin and of similar therapeutic efficacy in the treatment of mild-to-moderate essential hypertension. Unlike prazosin, the terminal-phase plasma half-life is long, at approximately 12 h, and effective blood pressure control is usually achieved with a once-daily dosing regimen. Once-daily dosing improves patient compliance, and good compliance to the therapeutic regimen is essential to effective treatment and the reduction of cardiovascular morbidity and mortality. Terazosin has generally been well tolerated in short-term and long-term studies. Unlike diuretics and beta-blockers, terazosin does not adversely affect the serum lipid profile. Indeed, beneficial changes in the serum lipid profile have been observed in patients with hypertension. In placebo-controlled trials, total serum cholesterol and the combined low-density plus very-low-density lipoprotein cholesterol fraction were significantly reduced from baseline in the terazosin-treated group when compared with the placebo-treated group. In addition, terazosin tended to produce increases from baseline in the high-density lipoprotein cholesterol fraction and decreases in serum triglyceride levels. Once-daily dosing and a favorable impact on the serum lipid profile support the use of terazosin as first-choice treatment for mild-to-moderate essential hypertension.