IPSS is lower in hypertensive patients treated with angiotensin‐II receptor blocker: Posthoc analyses of a lower urinary tract symptoms population

Ito, Hiroki; Taga, Minekatsu; Tsuchiyama, Katsuki; Akino, Hironobu; Yokoyama, Osamu

doi:10.1002/nau.22267

Cited by 31 publications

(47 citation statements)

References 19 publications

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“…[33] In the other study by Ito et al, investigators found CA users had a significantly higher mean score compared to non-treated hypertensive patients. [32] The authors commented that contrary to what they had expected, “sub-scores for intermittency, not for storage symptoms, were worse in patients with CA treatment in this study.” This finding is consistent with that of Hall et al Interestingly, in Ito et al’s study men taking angiotension receptor antagonists were found to have significantly lower IPSSs, yet there were no significant differences in quality of life across the antihypertensive classes.…”

Section: Discussioncontrasting

confidence: 77%

“…The first study of 3790 Japanese men suffering from LUTS looked at the association between LUTS and hypertension. [32] The study revealed that patients on CAs had a statistically significantly higher IPSS 19.6 compared to 18.2 for patients with no treatment for hypertension, p<0.05. Patients on angiotensin receptor blockers scored significantly lower IPSS, while patients on angiotensin converting enzyme (ACE) inhibitors were shown to have scores not significantly different to the no-treatment group.…”

Section: Discussionmentioning

confidence: 81%

“…Patients on angiotensin receptor blockers scored significantly lower IPSS, while patients on angiotensin converting enzyme (ACE) inhibitors were shown to have scores not significantly different to the no-treatment group. [32] The other epidemiological study from Boston investigated the association between common antihypertensive medication use and LUTS in 5503 males and females. [33] The Boston area community health (BACH) survey demonstrated a high prevalence of LUTS in women CA users especially for those <55 years old (nocturia: OR = 2.65, 95% CI: 1.04–6.74; voiding: OR = 3.84, 95% CI: 1.24–11.87).…”

Section: Discussionmentioning

confidence: 99%

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Calcium Antagonists Use and Its Association with Lower Urinary Tract Symptoms: A Cross-Sectional Study

2013

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BackgroundLower urinary tract symptoms (LUTS) have been reported amongst the side effects of calcium antagonists (CA). CAs act on the bladder by affecting the ability of the detrusor muscle to create enough contractile force to overcome obstruction to normal voiding. We aimed to determine the relationship between CA use and LUTS in general medical inpatients.Methods and FindingsIn this cross-sectional study we recruited 278 medical inpatients (including 85 CA users) aged ≥40 (72.1±13.7) years. LUTS was assessed using the International Prostate Symptoms Score (IPSS) questionnaire. A Logistic regression model using a ‘backwards-elimination’ strategy was used to identify variables associated with LUTS and for calculating the adjusted odds ratios and the 95% confidence intervals (CI). After adjusting for other risk factors and drugs, patients on amlodipine/nifedipine and diltiazem/verapamil (compared to non-users) were more likely to suffer from severe LUTS [Males: 12.45(CI: 1.57–98.63) and Females: 7.75(CI: 0.94–63.94)] and moderate-to-severe LUTS [Males: 17.43(CI: 2·26–134.39) and Females: 47.8(CI: 6.22–367.37)]. Patients on felodipine/lercanidipine were less likely to suffer from either severe or moderate-to-severe LUTS. Further, 19 (22.4%) CA-users were on treatment for LUTS compared to 18 (9.3%) of the non-users group, p = 0.003. Both male and female CA-users were three times more likely to be on alpha-blockers than non-users, p<0.001. CA-users were more likely to have undergone urinary tract-related surgery (Males: two times, p = 0.07 and females: nine times, p = 0.029). The study was limited by the fact that a causal relationship could not be established between CA use and LUTS.ConclusionsOur results demonstrate an association between CA use and an increasing severity of LUTS. They also demonstrate that CA-users are more likely to have medical or surgical treatment for LUTS. However, these CA’s effects on LUTS vary, and the use of highly vascular selective agents does not appear to pose significant risk.

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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Calcium Antagonists Use and Its Association with Lower Urinary Tract Symptoms: A Cross-Sectional Study

2013

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“…12 This fact suggests that angiotensin II receptors play a role in urinary bladder function. The pathophysiological role of angiotensin II in the cardio-vascular system was established in detail.…”

Section: Discussionmentioning

confidence: 99%

The angiotensin II receptors type 1 blockage affects the urinary bladder activity in hyperosmolar-induced detrusor overactivity in rats: Preliminary results

Juszczak¹,

Maciukiewicz²

2017

Adv Clin Exp Med

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“…The lower urinary tract harbors a local renin-angiotensin system [30] that contributes to stress incontinence in animal models [31]. A post hoc analysis of antihypertensive patients treated with AT 1 receptor blockers revealed lesser lower urinary tract symptoms than the untreated subjects [32]. Here, we have demonstrated that blocking AT 1 receptors sensitizes denuded and intact human detrusor to noradrenaline relaxation suggesting that local angiotensin II production counteracts smooth muscle relaxation by noradrenalin and is also involved in blunting the noradrenaline relaxation in the presence of urothelium.…”

Section: Discussionmentioning

confidence: 99%

Pharmacological Modulation of Mucosa-Related Impairment of β-Adrenoceptor-Mediated Relaxation in Human Detrusor

et al. 2015

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Objectives: The mucosa of human detrusor strips impairs catecholamine-induced relaxation. In order to elucidate which signal transduction pathways are involved in this cross talk between the mucosa and detrusor, we have studied the effects of several pharmacological agonists and antagonists on noradrenaline-mediated relaxation in intact and mucosa-denuded detrusor strips. Patients and Methods: Strips of detrusor tissue were obtained from patients who had undergone cystectomy for bladder cancer and were set up for force measurement. KCl- or carbachol-precontracted strips were relaxed with increasing concentrations of noradrenaline in the absence and in the presence of nitric oxide synthase inhibitor, L-NAME; P2X-receptor antagonist, PPADS; ET_A-receptor antagonist, BQ-123; ET_B-receptor antagonist, BQ-788; cyclooxygenase inhibitor, diclofenac; AT₁-receptor antagonist, candesartan; and NK₁-receptor antagonist, L-703,606. Results: In intact strips, KCl-stimulated force was enhanced by all blockers; carbachol-stimulated force increased with L-703,606. In denuded strips, only L-NAME augmented the KCl-stimulated contraction. Noradrenaline relaxed the precontracted detrusor strips to a significantly larger extent and at lower concentrations in denuded than in intact strips. L-NAME, PPADS and BQ-123/BQ-788 had little effect on noradrenaline-induced relaxation, whereas diclofenac, candesartan and L-703,606 sensitized intact carbachol-stimulated detrusor strips to noradrenaline-induced relaxation. Conclusion: Inhibition of the noradrenaline-induced relaxation of precontracted human detrusor strips by the mucosa is attenuated by diclofenac, candesartan and L-703,606 suggesting the involvement of prostanoids, angiotensin and neurokinin pathways. Further experiments are required to unravel the exact mechanisms.

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IPSS is lower in hypertensive patients treated with angiotensin‐II receptor blocker: Posthoc analyses of a lower urinary tract symptoms population

Abstract: The IPSS is lower in patients with HT treated with ARB. Other drugs for HT, including ACE-I and CCB, did not improve the IPSS.

Cited by 31 publications

References 19 publications

Calcium Antagonists Use and Its Association with Lower Urinary Tract Symptoms: A Cross-Sectional Study

Calcium Antagonists Use and Its Association with Lower Urinary Tract Symptoms: A Cross-Sectional Study

The angiotensin II receptors type 1 blockage affects the urinary bladder activity in hyperosmolar-induced detrusor overactivity in rats: Preliminary results

Pharmacological Modulation of Mucosa-Related Impairment of β-Adrenoceptor-Mediated Relaxation in Human Detrusor

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