Department of Internal Diseases, Hypertension and Angiology, Medical University of Warsaw, Warsaw, Poland.
Urology. 2013 Sep;82(3):660-5. doi: 10.1016/j.urology.2013.03.087.
To assess the influence of carvedilol, an α- and β-blocker, on lower urinary tract symptoms (LUTS) and urine flow in hypertensive patients with benign prostatic hyperplasia (BPH).
Fifty men were included in this double blind crossover study with placebo. After initial screening, participants were randomized to the carvedilol or the enalapril group, with cross over after 3 months. Doses of both drugs were uptitrated or additional therapy was introduced to ensure normal control of blood pressure (BP). Urologic assessment included uroflowmetry (average [Qavg] and maximum urinary flow rate [Qmax]), postvoid residual urine volume (PVR), International Prostate Symptom Score (IPSS), and prostate-specific antigen (PSA).
After carvedilol or enalapril administration, BP values were significantly reduced, whereas heart rate decreased only in the carvedilol group. Basal urologic values for carvedilol and enalapril were similar: Qavg, 7.8 ± 0.9 and 8.1 ± 0.6 mL/s; Qmax, 13.2 ± 1.5 and 13.7 ± 0.9 mL/s; PVR, 86.1 ± 13.2 and 85.6 ± 11.7 mL; and IPSS, 13.2 ± 0.9 and 12.3 ± 0.8 points, respectively. After treatment with carvedilol, PVR and IPSS significantly decreased (48.2 ± 11.7 mL, 9.0 ± 0.8 points, respectively; P <.001), whereas Qavg and Qmax increased (10.3 ± 0.9 mL/s, 16.5 ± 1.4 mL/s, respectively; P <.001). In the enalapril group, all of these values remained unchanged.
Carvedilol, compared with enalapril, has a positive influence on LUTS related to BPH in patients with hypertension. Thus, therapy with carvedilol may be considered in hypertensive patients with BPH. Further studies on the urologic benefit from long-term use of the drug are warranted.
评估卡维地洛（一种 α 和 β 受体阻滞剂）对患有良性前列腺增生（BPH）的高血压患者的下尿路症状（LUTS）和尿流的影响。
这项双盲交叉研究纳入了 50 名男性患者，采用安慰剂对照。初步筛选后，参与者被随机分为卡维地洛或依那普利组，3 个月后交叉。两种药物的剂量均进行滴定或引入额外治疗，以确保血压（BP）正常控制。泌尿科评估包括尿流率（平均 [Qavg] 和最大尿流率 [Qmax]）、残余尿量（PVR）、国际前列腺症状评分（IPSS）和前列腺特异性抗原（PSA）。
给予卡维地洛或依那普利后，BP 值显著降低，而只有在卡维地洛组心率才下降。卡维地洛和依那普利的基础泌尿科值相似：Qavg 分别为 7.8 ± 0.9 和 8.1 ± 0.6 mL/s；Qmax 分别为 13.2 ± 1.5 和 13.7 ± 0.9 mL/s；PVR 分别为 86.1 ± 13.2 和 85.6 ± 11.7 mL；IPSS 分别为 13.2 ± 0.9 和 12.3 ± 0.8 分。卡维地洛治疗后，PVR 和 IPSS 显著降低（分别为 48.2 ± 11.7 mL 和 9.0 ± 0.8 分；P<.001），而 Qavg 和 Qmax 增加（分别为 10.3 ± 0.9 mL/s 和 16.5 ± 1.4 mL/s；P<.001）。依那普利组中，所有这些值均无变化。
与依那普利相比，卡维地洛对高血压合并 BPH 患者的与 BPH 相关的 LUTS 具有积极影响。因此，卡维地洛治疗可考虑用于高血压合并 BPH 患者。需要进一步研究该药长期使用对泌尿科的获益。
