Pheochromocytoma: an approach to antihypertensive management.
Pheochromocytoma and paragangliomas are rare tumors of chromaffin tissue that secrete catecholamines either intermittently or continuously, producing hypertension with a constellation of symptoms and signs that can be frightening to the patient and that continue to provide perplexing problems for clinicians. With surgical treatment, symptoms will be relieved and hypertension normalized or ameliorated for patients who do not have malignant tumors. Appropriate antihypertensive drugs are used to manage hypertension, to control associated cardiovascular symptoms, and to prepare patients for operation. The question debated most often regarding medical therapy of pheochromocytoma is whether antihypertensive treatment regimens other than nonspecific alpha-blockade are just as effective and safe. Understanding the pathophysiologic mechanisms that sustain the hypertension and the pharmacology of antihypertensive agents allows better selection of antihypertensive therapy.
Bravo
Emmanuel L
EL
Cleveland Clinic Foundation, 9500 Euclid Avenue, Desk A51, Cleveland, OH 44195, USA. bronofs@ccf.org
D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000628:therapy; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002395:Catecholamines / Q000097:blood; D003000:Clonidine / Q000627:therapeutic use; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology*; D009478:Neuropeptide Y / Q000097:blood; D010643:Phenoxybenzamine / Q000627:therapeutic use; D010673:Pheochromocytoma / Q000150:complications* / Q000628:therapy
D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D002395:Catecholamines; D009478:Neuropeptide Y; D010643:Phenoxybenzamine; D003000:Clonidine