Martell N, Luque M
Hypertension Unit, Hospital Clínico San Carlos, Madrid, Spain.
J Clin Hypertens (Greenwich). 2001 Jul-Aug;3(4):218-23. doi: 10.1111/j.1524-6175.2001.00459.x.
The purpose of this study was to evaluate the efficacy and safety of the addition of doxazosin in the treatment of hypertensive patients who are being treated on another antihypertensive drug. The open-labeled, noncomparative, multicenter study was carried out in 2363 male hypertensive outpatients > 40 years of age, under reasonable control with single antihypertensive drug treatment (diastolic blood pressure < 95 mm Hg), and diagnosed with benign prostatic hypertrophy. Doxazosin was started at a dose of 1 mg/day, which was increased at 2-week intervals to 2 mg/day and 4 mg/day. The study lasted 14 weeks. Blood pressure and heart rate were measured at each of the visits. At baseline and after 14 weeks of treatment, prostatism symptoms were quantified with the International Prostate Symptom Score and quality of life was determined with the American Urology Association Committee Guidelines. Adverse effects were recorded. At the fourth visit, when the patients were taking 4 mg of doxazosin, the blood pressure reduction was 10.7 +/- 3/7.1 +/- 7.1 mm Hg. The decrease in diastolic blood pressure was significantly more marked in patients treated with beta blockers than in patients on calcium antagonists or angiotensin-converting enzyme inhibitors. For systolic blood pressure, decreases were larger in patients treated with diuretics than with calcium antagonists or angiotensin-converting enzyme inhibitors. Prostatism symptoms decreased from 15 +/- 5.8 points to 7.9 +/- 4.3 points (p is less than 0.001) and quality of life improved. Tolerability was good, with only a 4.4% cumulative incidence of adverse effects related to doxazosin. The patients who experienced adverse effects were older and their final blood pressures were lower. The results of this open-label study suggest that the addition of doxazosin to another antihypertensive drug in hypertensive patients with benign prostatic hypertrophy is well tolerated and leads to a reduction in prostatic symptoms. The additional beneficial effects on blood pressure suggest that the use of doxazosin may provide a rational approach to this category of patients.(c)2001 Le Jacq Communications, Inc.
本研究的目的是评估在接受另一种抗高血压药物治疗的高血压患者中加用多沙唑嗪的疗效和安全性。这项开放标签、非对照、多中心研究在2363名年龄大于40岁的男性高血压门诊患者中进行，这些患者接受单一抗高血压药物治疗且血压得到合理控制（舒张压<95mmHg），并被诊断为良性前列腺增生。多沙唑嗪起始剂量为1mg/天，每2周递增至2mg/天和4mg/天。研究持续14周。每次访视时测量血压和心率。在基线期和治疗14周后，用国际前列腺症状评分对前列腺增生症状进行量化，并用美国泌尿外科学会委员会指南确定生活质量。记录不良反应。在第四次访视时，当患者服用4mg多沙唑嗪时，血压降低了10.7±3/7.1±7.1mmHg。与使用钙拮抗剂或血管紧张素转换酶抑制剂的患者相比，接受β受体阻滞剂治疗的患者舒张压下降更为显著。对于收缩压，使用利尿剂治疗的患者下降幅度大于使用钙拮抗剂或血管紧张素转换酶抑制剂的患者。前列腺增生症状从15±5.8分降至7.9±4.3分（p<0.001），生活质量得到改善。耐受性良好，与多沙唑嗪相关的不良反应累积发生率仅为4.4%。出现不良反应的患者年龄较大，其最终血压较低。这项开放标签研究的结果表明，在患有良性前列腺增生的高血压患者中，在另一种抗高血压药物基础上加用多沙唑嗪耐受性良好，并可减轻前列腺症状。对血压的额外有益作用表明，使用多沙唑嗪可能为这类患者提供一种合理的治疗方法。(c)2001 Le Jacq Communications, Inc.
