Influence of antihypertensive drugs on psychosensory and psychomotor performance tests

Centrally-acting, adrenergic neurone-blocking and alpha-receptor-blocking antihypertensive drugs are unacceptable for use by aircrew because of the high incidence of postural hypotension and sedation. Newer agents, including the angiotension-converting enzyme inhibitors, nifedipine and minoxidil should not be considered until more data are available. Beta-adrenoceptor blocking drugs can be shown to interfere with the execution of tasks under laboratory conditions in therapeutic doses and in higher doses may produce subjective feelings of sedation and reduced concentration. A peripheral component involving a direct effect on skeletal muscle function also cannot be excluded. The use of beta-blocking agents in aircrew requires individual assessment with regard to side-effects and the use of a limited number of compounds. Although probably the least likely to interfere with performance, individual diuretic drugs require to be compared and scrutinized carefully for their incidence of CNS effects and for possible effects on the execution of complex tasks.