Abstract
The relationship between benzodiazepine and hypertension has long been known and well-documented, but, the character of γ-aminobutyric acid (GABA)-A and GABA-like peripheral receptors (PBR complexes) in blood pressure regulation is intricate. However, this ‘literature review’-facilitated argumentative paper went through an inclusive view into past studies, meta-analyses and case studies that had underlined the potential antihypertensive roles of benzodiazepines, which exert their antihypertensive mechanisms through GABA-A receptors in the CNS alongside PNS and GABA like receptors (PBR Complexes) in vasoactive smooth muscles and blood vessels via “tempering anion channels (Ca++ channels)” as well as “modulating glucocorticoid synthesis” in many parts including suprarenal gland and brain by directly acting on PBR complexes of inner mitochondrial membrane close to voltage-gated anion channels and cholesterol transports along with “exerting adenosine reuptake inhibitor” activities throughout the CVS including coronary vessels that could potentially prevent morbidity and CVDs in hypertensive elderly. Despite benzodiazepine’s antihypertensive effects on multiple cardiovascular clinical incidences and emergencies including their use as a prophylaxis for hypertensive elderly and adult, very few past studies were found to have addressed benzodiazepine’s antihypertensive action, that remains a critical limitation and challenge to this paper, as its motto is to find out the correlation between benzodiazepine and their CVS effects alongside the risks and benefits of benzodiazepine in hypertensive patients, in particular in elderly. Despite the limitations, this paper had reached a conclusion following an argument on findings of past studies, that, certain benzodiazepines could be useful as an antihypertensive agent with or without conventional anti-HTN. However, in case of elderly, often antidepressants are prescribed in patients with hypertension despite their increasing risks, but use of benzodiazepines in elderly could decrease a number of risks and therefore it could be said that benzodiazepines are comparatively safer to use in elderly as an antihypertensive, while before introducing antidepressants, the patients’ history should provide enough evidences that the risks such as suicidal ideation, mania and exacerbation of underlying psychological disorders might not be outweighing the benefits. Alongside this, it could also be said that the long- and centrally-acting benzodiazepines such as Diazepam and Clonazepam act better to lower mean BP in both adults and elderly, but those exerting both peripheral and central actions to reduce mean BP such as intermediate-acting bromazepam, showed better response in elderly. However, further researches ought to be conducted to reach a comprehensive resolution.