Hughes Jeffery D, Coles Mark A, Joyce Andrew
School of Pharmacy, Curtin University, Perth, Western Australia.
Qual Prim Care. 2011;19(4):223-31.
Lower urinary tract symptoms (LUTS) are common and prevalence increases with age. In men, voiding symptoms are more commonly encountered than storage symptoms. LUTS are often associated with chronic diseases but their pathophysiology requires further study. We aimed to determine whether calcium channel blockers (CCBs) worsened, improved or did not alter symptoms of urinary obstruction in males aged 45 years and above with medical conditions associated with urinary obstruction.
A cohort retrospective observational study was undertaken to identify the effect of the use of CCBs on LUTS in males over 45 years of age. Participants were recruited from four community pharmacies and a general practitioner surgery. Eligible participants provided informed consent and were administered a standardised questionnaire (IPSS) to obtain information on LUTS and quality of life (QOL) prior to and after commencement of CCB therapy.
Thirty-eight males were enrolled in the study, and their ages of ranged from 46.2 to 88.7 years, with the mean age being 66.9 years (95% CI: 63.9-69.9). The mean IPPS score prior to commencing a CCB was 3.13 (95% CI: 2.09-4.17) compared to 9.82 (95% CI: 7.83-11.80) whilst on the drug (P<0.001). After adjusting for other medications and conditions which may contribute to LUTS, and for the natural progression of LUTS with ageing, the change remained significant. The increase in IPPS score was associated with a significant decline in the respondents' QOL.
The results of this study suggest that in middle-aged males the introduction of a CCB may be associated with worsening of LUTS, and an associated decline in QOL, although this will need to be confirmed in large prospective studies. However, given the common use of these agents in males to treat a range of cardiovascular conditions, we would suggest that men prescribed a CCB should be questioned about urinary symptoms before and after commencing treatment.
下尿路症状（LUTS）很常见，且患病率随年龄增长而增加。在男性中，排尿症状比储尿症状更常见。LUTS常与慢性疾病相关，但其病理生理学仍需进一步研究。我们旨在确定钙通道阻滞剂（CCB）是否会加重、改善或不改变45岁及以上患有与尿路梗阻相关疾病的男性的尿路梗阻症状。
进行了一项队列回顾性观察研究，以确定使用CCB对45岁以上男性LUTS的影响。参与者从四家社区药店和一家全科医生诊所招募。符合条件的参与者提供了知情同意书，并在CCB治疗开始前后接受了标准化问卷（IPSS），以获取有关LUTS和生活质量（QOL）的信息。
38名男性参与了该研究，他们的年龄在46.2至88.7岁之间，平均年龄为66.9岁（95%CI：63.9-69.9）。开始使用CCB之前的平均IPPS评分为3.13（95%CI：2.09-4.17），而用药期间为9.82（95%CI：7.83-11.80）（P<0.001）。在调整了可能导致LUTS的其他药物和疾病，以及LUTS随年龄的自然进展后，这种变化仍然显著。IPPS评分的增加与受访者QOL的显著下降相关。
本研究结果表明，在中年男性中，使用CCB可能与LUTS恶化及QOL下降有关，尽管这需要在大型前瞻性研究中得到证实。然而，鉴于这些药物在男性中常用于治疗一系列心血管疾病，我们建议在开始治疗之前和之后，应对开具CCB处方的男性询问尿路症状。
