Which class of secondary anti-hypertensive agents is rarely prescribed by clinicians?

The class of secondary anti-hypertensive agents that is rarely prescribed by clinicians is the peripheral adrenergic antagonists. This class of medications works primarily by blocking the action of norepinephrine on adrenergic receptors in the peripheral nervous system, leading to vasodilation and reduced blood pressure. However, their use has become less common due to a combination of factors including side effects, lower efficacy compared to other antihypertensive classes, and the availability of more effective and better-tolerated medications.

In contrast, centrally acting α2 agonists are still utilized, particularly for certain patient populations, despite being secondary agents. Calcium channel blockers and ACE inhibitors are widely used first-line treatments for hypertension, offering effective blood pressure control along with favorable side effect profiles. This makes peripheral adrenergic antagonists less favorable compared to these more reliable and effective alternatives in current clinical practice.