Which drug class can lead to hypotension due to systemic vasodilation?

Inodilators, which are a subclass of medications that possess both inotropic (increasing the force of heart contractions) and vasodilating properties, can lead to hypotension due to systemic vasodilation. These agents work by relaxing the vascular smooth muscle, which results in a decrease in systemic vascular resistance and subsequently lowers blood pressure. The combined effects of improved cardiac output (from the inotropic action) and systemic vasodilation can lead to significant drops in blood pressure, particularly in susceptible populations or when used inappropriately.

The other drugs listed affect blood pressure but through different mechanisms. Alpha blockers primarily work by blocking alpha-adrenergic receptors, leading to vasodilation and potentially hypotension, but their mechanism is more direct blocking of sympathetic stimulation. Calcium channel blockers are designed to inhibit calcium influx in cardiac and smooth muscle, leading to vasodilation but also affecting cardiac contractility, which might not lead to hypotension as directly as inodilators under many clinical settings. Angiotensin II inhibitors, such as ACE inhibitors or angiotensin receptor blockers, lower blood pressure by blocking the renin-angiotensin-aldosterone system, but their primary effect on hypertension is not directly through systemic vasodilation in the manner seen with