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Asked 5 Sep 2019 Paul Mackey, Doctor/physician - primary care/family practice, CA

I have the recollection that alpha blockers are not recommended first line because of adverse CCD outcomes (was it ALLHAT?) but, really, should I be using them at all in primary care for hypertension?

Had 74 yo gentlemen today on terazosin and ramipril for BP. Recent ER visit for hypotension recorded at home 90-110 systolic. In ER and here BP 120-130 systolic. ECG in ER: bigemeny. Holster in May short run asymptomatic VT. Normal ECHO in May, EF 55-60%. I’m suspicious that recent episode may have been symptomatic VT (Ix and referral underway) but is terazosin doing more harm than good?
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