Alpha-adrenergic blocking drugs in the management of benign prostatic hyperplasia: Interactions with antihypertensive therapy

Management of benign prostatic hyperplasia [BPH) is often complicated by co ncomitant hypertension, a life-threatening condition that must be managed o ptimally. Many of the cr blockers used to treat BPH also decrease blood pre ssure, and terazosin and doxazosin have been shown to have significant card iovascular side effects, such as asthenia/fatigue, postural hypotension, an d dizziness when used to treat. BPH patients. Furthermore, these drugs are not first-line therapies for hypertension, and the majority of hypertensive BPH patients will be receiving other antihypertensive agents. Therefore, i t is possible that the introduction of these drugs will affect blood pressu re control, at least temporarily, with possible adverse effects. In contras t, the selective alpha(1A) blocker tamsulosin does not appear to have signi ficant cardiovascular side effects and produces minimal blood pressure redu ctions. Therefore, urologists can choose either to use alpha blockers to tr eat both hypertension and BPH or to treat BPH using or blockers that do not interact with antihypertensive therapy. This review focuses on the alpha b lockers currently being used to treat BPH, their effects on the cardiovascu lar system, and their interaction with antihypertensive drugs. (C) 1999, El sevier Science Inc. All rights reserved.