Urapidil : revue des études récentes

Urapidil is an antihypertensive agent with both central and peripheral effects. It induces an α1-adrenoreceptor blockade responsible for a decrease in peripheral arterial resistances. Urapidil also induces an inhibition of sympathetic tone by a central mechanism of action involving both α1 adrenergic blockade and a serotoninergic agonist activity on 5HT1A receptors. Urapidil does not induce reflex tachycardia and has bronchodilating properties. Since the last review in 1998, several studies have pointed out its effects in various clinical situations: Urapidil can be safely used in hypertensive emergency management in both pre- and postoperative periods such as pheochromocytoma surgery. Urapidil is also adapted to the treatment of hypertension during electroconvulsivotherapy and preeclampsia. Urapidil improves the hemodynamic status and cardiac index in patients with pulmonary arterial hypertension. The lack of vasodilation associated-tachycardia is beneficial to patients with coronary artery disease. Coronary artery flow is increased after angioplasty with urapidil administration, whether it was carried out as an emergency in acute coronary syndrome or scheduled procedure. Finally, urapidil's α1-adrenoreceptor blocking effect may release a neurogenic or obstructive voiding dysfunction.