Alpha blockers to reduce blood pressure

Alpha blockers are not recommended for first-line therapy of elevated blood pressure (BP) because they may increase the rate of cardiovascular events (especially heart failure) compared to other BP-lowering drugs. They may be useful in males with both elevated BP and benign prostatic hypertrophy, as they improve urine stream in benign prostatic hypertrophy.

If an alpha blocker is considered appropriate to reduce BP, use:

Alpha blockers can cause postural hypotension, particularly after the first dose. To minimise the risk of falls, start or resume therapy at the lowest dose, increase the dose slowly, monitor standing BP, and warn patients of this effect.