Influence of hypertension on lower urinary tract symptoms in benign prostatic hyperplasia

Abstract

Aim : To clarify the influence of hypertension on lower urinary tract symptoms (LUTS) we examined the relationship between blood pressure, LUTS, and the effect of terazosin on LUTS in patients with benign prostatic hyperplasia (BPH). Methods : The subjects were patients who had LUTS and BPH. They were treated with terazosin (1 mg, twice-a-day) for 12 weeks. Calculation of the International Prostate Symptom Score (IPSS), measurement of blood pressure, and uroflowmetry were performed before and after 12 weeks of therapy. Patients were divided into a normotensive (NT) group and a hypertensive (HT) group at the time of first examination. Results : The IPSS for urinary frequency and nocturia in BPH-HT patients ( n = 21; mean age, 71 years) were significantly higher than those in the BPH-NT patients ( n = 21; mean age, 69 years) before the administration of terazosin. The total IPSS the BPH-HT patients was also significantly higher than that of the BPH-NT patients. There were no differences of uroflowmetric parameters between the two groups. After 12 weeks of therapy, systolic and diastolic blood pressure decreased in the BPH-HT patients, but not in the BPH-NT patients. However, the systolic pressure of the BPH-HT patients was still significantly higher than that of the BPH-NT patients. The score for each IPSS parameter decreased in both groups, but the difference of the score between the two groups increased. Conclusion : Hypertension may worsen LUTS and may decrease the improvement of symptoms by terazosin.

High-Dose Terazosin Therapy (5 mg) in Korean Patients with Lower Urinary Tract Symptoms with or without Concomitant Hypertension: A Prospective, Open-Label Study

“…A previous study showed that hypertensive BPH patients have more severe LUTS than normotensive BPH patients, and that hypertension worsens LUTS and may reduce the efficacy of terazosin 2. However, in the present study, clinical parameters at baseline were similar in the two study groups.…”

“…However, alpha1-adrenoceptor antagonists are not first-line therapies for hypertension, and the majority of hypertensive BPH patients will be receiving other antihypertensive agents that may increase the risk of drug interactions and side-effects. In addition, hypertension may reduce the effect of an alpha1-adrenoceptor antagonist on lower urinary tract symptoms (LUTS) 2. Furthermore, although 5 or 10 mg terazosin daily been routinely used in North America and Europe, terazosin is equally effective for treating symptomatic BPH in Asian patients at lower doses than those used in the West 3-5.…”

Circadian rhythm of blood pressure in patients with benign prostatic hyperplasia

“…We also found a significant association between nocturia and non-dipping in patients with BPH. We believe that the difference observed between the two groups (20) was due to the presence or absence of nocturia or BPH. Accordingly, we suggest that increased sympathetic activity may be a common pathophysiological factor for non-dipping and nocturia.…”

“…A retrospective analysis [19] of 9857 men with BPH revealed that symptoms of BPH were more frequent in hypertensive patients. In another study by Sugaya et al [20], it was found that hypertension may worsen LUTS. Our groups were well matched with regard to their hypertension status, with similar percentages of hyper-and normotensive subjects in each group.…”

Efficacy and safety of fesoterodine treatment for overactive bladder symptoms in elderly women with and without hypertension

“…Premenopausal women are considered to be protected from HT relative to age‐matched men, but this protection is lost after the onset of menopause . The majority of female OAB patients are elderly, and HT is hypothesized to be a risk factor for developing OAB …”