Generally, ai-blockers are considered as inferior agents and should not be used as monotherapy. The ALLHAT trial had an ai-blocker arm that was discontinued early as terazosin was associated with an increase in cardiovascular events. aiBlockers may be considered as add-on therapy to other agents (i.e., 3rd or 4th line) when hypertension is not adequately controlled. In addition, they may have a specific role in the antihypertensive regimen for elderly males with prostatism; however, their use is often curtailed by complaints of syncope, dizziness, or palpitations following the first dose and orthostatic hypotension with chronic use. The roles of doxazosin, terazosin, and prazosin in the management of patients with hypertension are limited due to the paucity of outcome data and the absence of a unique role for special populations or compelling indications from JNC 7.

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