Lowe F C, Olson P J, Padley R J
Department of Urology, St. Luke's/Roosevelt Hospital Center and Columbia University College of Physicians and Surgeons, New York, New York, USA.
Urology. 1999 Jul;54(1):81-5. doi: 10.1016/s0090-4295(99)00057-6.
To review and assess the cardiovascular safety of the alpha1-blocker terazosin when used to treat symptomatic benign prostatic hyperplasia (BPH) in patients taking concurrent antihypertensive medications.
This retrospective analysis focused on blood pressure changes and blood pressure-related side effects in 555 of 2084 patients randomized to either terazosin or placebo in the Hytrin Community Assessment Trial (HYCAT) study who were following either single or combination antihypertensive regimens (treated patients). We also compared results in normotensive and hypertensive patients, whether treated or not.
The addition of terazosin lowered mean systolic blood pressure by 5.3 mm Hg for untreated patients and 6.7 mm Hg for treated patients. For patients hypertensive on entry, mean reductions in systolic blood pressure in those untreated and treated were 12.1 and 11.1 mm Hg, respectively. The addition of terazosin to an existing antihypertensive regimen had its greatest impact (a mean reduction of 12.3 mm Hg) in those receiving diuretic therapy alone. Diastolic pressure changes followed a similar pattern. The incidences of blood pressure-related side effects in patients on terazosin were comparable between untreated (13.5%) and treated patients (14.3%), as were premature withdrawal rates, with 4.2% of untreated patients and 4.5% of treated patients withdrawing due to blood pressure-related side effects.
Terazosin can be safely used to treat patients with symptomatic BPH regardless of their blood pressure status and antihypertensive regimen. Terazosin may be safely added to ongoing antihypertensive therapy.
回顾并评估α1受体阻滞剂特拉唑嗪用于治疗正在服用抗高血压药物的有症状良性前列腺增生（BPH）患者时的心血管安全性。
这项回顾性分析聚焦于在Hytrin社区评估试验（HYCAT）研究中随机接受特拉唑嗪或安慰剂治疗的2084例患者中的555例，这些患者采用单一或联合抗高血压方案（治疗患者），分析其血压变化和血压相关副作用。我们还比较了血压正常和高血压患者（无论是否接受治疗）的结果。
对于未治疗的患者，加用特拉唑嗪可使平均收缩压降低5.3 mmHg，对于接受治疗的患者可降低6.7 mmHg。对于入组时高血压的患者，未治疗和接受治疗的患者收缩压平均降低分别为12.1和11.1 mmHg。在仅接受利尿剂治疗的患者中，在现有抗高血压方案中加用特拉唑嗪的降压效果最为显著（平均降低12.3 mmHg）。舒张压变化遵循类似模式。接受特拉唑嗪治疗的患者中，未治疗患者（13.5%）和接受治疗患者（14.3%）的血压相关副作用发生率相当，提前停药率也相当，未治疗患者中有4.2%、接受治疗患者中有4.5%因血压相关副作用停药。
无论患者的血压状况和抗高血压方案如何，特拉唑嗪均可安全用于治疗有症状的BPH患者。特拉唑嗪可安全地添加到正在进行的抗高血压治疗中。
