DOXAZOSIN IN THE OLDER MALE - EFFICACY IN TREATING BENIGN PROSTATIC HYPERPLASIA

It is important to establish the efficacy of medical treatments for be nign prostatic hyperplasia (BPH) in older patients. Several studies in the USA and in Europe have demonstrated that doxazosin produces a dos e-dependent, statistically significant improvement in both the obstruc tive and irritative symptoms of BPH, and a significant increase in uri nary flow in both younger and older men. A recent analysis of data fro m the USA studies demonstrated that changes in the total symptom sever ity score and in the bothersomeness score were similarly improved in y ounger (<65 years) and older patients (greater than or equal to 65 yea rs). Doxazosin is also a first-line antihypertensive agent that has a favorable effect on many of the other risk factors for cardiovascular disease. The antihypertensive effect of doxazosin does not vary with a ge, thus offering benefit to older men with concomitant hypertension a nd BPH. Significantly, blood pressure is reduced to clinically relevan t levels only if patients are hypertensive - no clinically significant effects on blood pressure are seen in either younger or older normote nsive patients. The bioavailability and elimination half-life of doxaz osin are also not influenced by age. The kinetics of doxazosin (peak p lasma levels in 2-3 h; t(1/2) = 22 h) translate into a dynamic effect that produces a rapid onset of effect and is sustained throughout the day. In summary, doxazosin produces a balanced effect in older men, im proving the symptoms and uroflow in BPH, with the added benefit of a p ositive effect on several important risk factors for coronary heart di sease