Urology Journal

ISSN: 1735-1308

May-June 2021
Vol. 18 No. 03 (2021)

A Randomized Crossover Pilot Study Examining the Effect of Carvedilol and Terazosin plus Enalapril on Urinary Symptoms of Patients with Hypertension and Benign Prostatic Hyperplasia

Urology Journal, Vol. 18 No. 03 (2021), , Page 337-342
https://doi.org/10.22037/uj.v18i.5678

Abstract

Purpose: The present study aims to assess and compare the effects of carvedilol and terazosin plus enalapril on lower urinary tract symptoms (LUTS), the urine flow, and blood pressure (BP) in patients with moderate hypertension (HTN) and benign prostatic hyperplasia (BPH).


Materials and Methods: In this randomized crossover trial, a total of 40 men with HTN and LUTS symptoms were enrolled. The first group was treated with carvedilol, and the second one received terazosin plus enalapril. After eight weeks of treatment, the patients experienced a one-month washout period, and the treatments changed and continued for eight weeks. To diagnose BPH in the study, the international prostate symptom score (IPSS) questionnaire was used. Moreover, the prostate-specific antigen (PSA), the post-void residual (PVR) urine volume, and the maximum urinary flow rate (Q-max using the uroflowmetry test) were measured.


Results: Effect assessment results in this crossover trial illustrated neither carryover effects nor significant treatment effects on all primary outcomes (P > 0.05). Moreover, the results for the period effect indicated a significant reduction in BP (systolic and diastolic), PVR, and IPSS, yet a significant raise in Qmax.


Conclusion: The effects of carvedilol are similar to those of the combination of terazosin and enalapril in patients with moderate HTN and BPH in controlling LUTS. Carvedilol could be used as an appropriative drug in patients with moderate HTN and cardiac problems with LUTS of BPH. Further studies are recommended to be conducted to investigate and compare the efficacy of carvedilol with that of other alpha-blockers with a larger sample size and over a longer period of time.

Keywords:
  • Benign prostatic hyperplasia
  • blood pressure
  • carvedilol
  • IPSS
  • Qmax

How to Cite

Farshi, A., DalirAkbari, N., Zomorrodi, A., Khalili, M., & Mahmoudinezhad , M. (2021). A Randomized Crossover Pilot Study Examining the Effect of Carvedilol and Terazosin plus Enalapril on Urinary Symptoms of Patients with Hypertension and Benign Prostatic Hyperplasia. Urology Journal, 18(03), 337-342. https://doi.org/10.22037/uj.v18i.5678

References

Shrivastava A, Gupta VB. Various treatment options for benign prostatic hyperplasia: A current update. Journal of mid-life health. 2012;3(1):10-9. DOI:10.4103/0976-7800.98811.

Alan C, Kirilmaz B, Kocoglu H, Ersay AR, Ertung Y, Eren AE. Comparison of effects of alpha receptor blockers on endothelial functions and coagulation parameters in patients with benign prostatic hyperplasia. Urology. 2011;77(6):1439-43. DOI: 10.1016/j.urology.2010.10.019

Chiu G, Li S, Connolly PJ, Pulito V, Liu J, Middleton SA. (Arylpiperazinyl) cyclohexyl sufonamides: Discovery of α1a/1d-selective adrenergic receptor antagonists for the treatment of Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms (BPH/LUTS). Bioorg Med Chem Lett. 2007;18(2):640-4.DOI: https://doi.org/10.1016/j.bmcl.2007.11.068.

de Reijke TM, Klarskov P. Comparative efficacy of two alpha-adrenoreceptor antagonists, doxazosin and alfuzosin, in patients with lower urinary tract symptoms from benign prostatic enlargement. BJU international. 2004;93(6):757-62. DOI:10.1111/j.1464-410X.2003.04720.x

Vuichoud C, Loughlin KR. Benign prostatic hyperplasia: epidemiology, economics and evaluation. The Canadian journal of urology. 2015;22 Suppl 1:1-6.

Lewandowski J, Sinski M, Symonides B, Korecki J, Rogowski K, Judycki J, et al. Beneficial influence of carvedilol on urologic indices in patients with hypertension and benign prostatic hyperplasia: results of a randomized, crossover study. Urology. 2013;82(3):660-5. DOI:10.1016/j.urology.2013.03.087

Berrie C. Carvedilol More Effective Than Enalapril in Improving Benign Prostatic Hyperplasia in Hypertensive Males. Annual Congress of the European Society of Hypertension (ESH); london2012.

Kirby RS. Efficacy of doxazosin in normotensive and hypertensive patients with benign prostatic hyperplasia. Scandinavian journal of urology and nephrology Supplementum. 1995;168:29-33.

Michel MC, Heemann U, Schumacher H, Mehlburger L, Goepel M. Association of hypertension with symptoms of benign prostatic hyperplasia. The Journal of urology. 2004;172(4 Pt 1):1390-3.

Kapoor A. Benign prostatic hyperplasia (BPH) management in the primary care setting. The Canadian journal of urology. 2012;19 Suppl 1:10-7.

Rohrer CK, Page RL, 2nd, Shakar SF, Lindenfeld J. Carvedilol for the treatment of benign prostatic hypertrophy in patients with heart failure? Journal of cardiac failure. 2011;17(10):875-7. DOI:10.1016/j.cardfail.2011.05.009.

Dhaliwal AS, Habib G, Deswal A, Verduzco M, Souchek J, Ramasubbu K, et al. Impact of alpha 1-adrenergic antagonist use for benign prostatic hypertrophy on outcomes in patients with heart failure. The American journal of cardiology. 2009;104(2):270-5. DOI: 10.1016/j.amjcard.2009.03.030.

Major cardiovascular events in hypertensive patients randomized to doxazosin vs chlorthalidone: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). ALLHAT Collaborative Research Group. Jama. 2000;283(15):1967-75.

Harada K, Fujimura A. Clinical pharmacology of alpha1A selective and nonselective alpha1-blockers. BJU international. 2000;86 Suppl 2:31-4; discussion 4-5.

Yuan JQ, Mao C, Wong SY, Yang ZY, Fu XH, Dai XY, et al. Comparative Effectiveness and Safety of Monodrug Therapies for Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia: A Network Meta-analysis. Medicine. 2015;94(27):e974. DOI:10.1097/MD.0000000000000974

The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V). Archives of internal medicine. 1993;153(2):154-83.

Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. European heart journal. 2018;39(33):3021-104. DOI:10.1093/eurheartj/ehy339

Ayashi S, Assareh AR, Jalali MT, Olapour S, Yaghooti H. Role of antioxidant property of carvedilol in mild to moderate hypertensive patients: A prospective open-label study. Indian journal of pharmacology. 2016;48(4):372-6. DOI:10.4103/0253-7613.186206

Oelke M, Bachmann A, Descazeaud A, Emberton M, Gravas S, Michel MC, et al. EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. European urology. 2013;64(1):118-40. DOI:10.1016/j.eururo.2013.03.004

Okada H, Kawaida N, Ogawa T, Arakawa S, Matsumoto O, Kamidono S. Tamsulosin and chlormadinone for the treatment of benign prostatic hyperplasia. The Kobe University YM617 Study Group. Scandinavian journal of urology and nephrology. 1996;30(5):379-85. DOI:10.3109/00365599609181314

Okada H, Kamidono S, Yoshioka T, Okuyama A, Ozono S, Hirao Y, et al. A comparative study of terazosin and tamsulosin for symptomatic benign prostatic hyperplasia in Japanese patients. BJU international. 2000;85(6):676-81. https://doi.org/10.1046/j.1464-410x.2000.00608.x

  • Abstract Viewed: 0 times
  • 5678/pdf Downloaded: 0 times

Download Statastics

In case of persistent problems in registration, primary uploading of a submission or uploading of a revision, please send us the submission files on the journal email at:

urologyjournal@sbmu.ac.ir

and please attach the screenshot of the error or problem you encountered in uploading.

 

Make a Submission
Information
Keywords