Effects of alpha blocker "add on"treatment on blood pressure in symptomatic benign prostatic hyperplasia with or without concomitant hypertension

Abstract

We investigated the effects of add on treatment of alpha blocker (AB) on blood pressure (BP) and the safety of ABs in men with symptomatic benign prostatic hyperplasia (BPH) with or without hypertension. We retrospectively reviewed 2,924 BPH outpatients who took ABs at our institution between 2005 and 2009. BPH symptom severity, prostate volume, and BP were determined for 953 patients with their baseline data. BP and IPSS were measured within 2 months after AB treatment. Patients were assigned to four groups: group 1 had 272 normotensive patients with concomitant hypertensive medication; group 2 had 293 normotensive patients without the medication; group 3 had 216 hypertensive patients with concomitant medication, and group 4 had 172 hypertensive patients without the medication. The addition of AB lowered the mean systolic BP by 16.6 mmHg for group 3 and 8.6 mmHg for group 4, and diastolic BP by 18.0 mmHg for group 3 (p<0.05). However, normotensive groups on entry, irrespective of antihypertensive medication, showed no significant BP changes from baseline after ABs medication. In the hypertensive groups on entry, doxazosin GITS resulted in significant reductions in systolic BP from 142.2 to 134.9 mmHg and diastolic BP from 97.6 to 84.6 mmHg. When analyzed by AB regimen, the incidence of BP-related adverse events was comparable. AB therapy for BPH can have an appropriate and beneficial effect on BP, especially in baseline hypertensive patients. Doxazosin GITS treatment resulted in optimal management of BP within the normal range especially in the pharmacologically or physiologically hypertensive patients.