Which class of drugs may cause orthostatic hypotension?

Orthostatic hypotension refers to a drop in blood pressure that occurs when a person stands up from a sitting or lying position. It is particularly associated with medications that affect vascular tone and blood vessel constriction.

Alpha-1 antagonists are a class of drugs that block alpha-1 adrenergic receptors, which are responsible for the contraction of smooth muscles in blood vessels. When these receptors are blocked, vasodilation occurs, leading to decreased peripheral vascular resistance. This can result in a significant drop in blood pressure upon standing, hence causing orthostatic hypotension. Patients on alpha-1 antagonists must be particularly cautious when changing positions, especially when transitioning from sitting or lying down to standing.

While other drug classes mentioned can have effects on blood pressure, they are not primarily known for causing orthostatic hypotension in the same way alpha-1 antagonists do. For instance, beta-1 antagonists primarily impact heart rate and contractility, calcium channel blockers mainly influence myocardial contractility and vascular smooth muscle, and ACE inhibitors are more involved in modifying the renin-angiotensin-aldosterone system rather than causing direct postural changes in blood pressure.