THE TREATMENT OF BENIGN PROSTATIC HYPERPLASIA WITH ALPHA-BLOCKERS IN MEN OVER THE AGE OF 80 YEARS

Objective To determine the safety and efficacy of alpha blockade with doxazosin and terazosin in men over the age of 80 years with symptomat ic benign prostatic hyperplasia (BPH). Patients and methods Thirty-six men (mean age 83.6 years, sn 5.6, range 80-96) received either doxazo sin 4 mg (11 men) or 8 mg (10 men), or terazosin 5 mg (five men) or 10 mg (10 men), once daily at night. Twenty-eight men (78%) were on othe r antihypertensive medication; the type and dosage were not changed du ring the study. Efficacy and safety were assessed using measurements o f peak urinary flow rate, symptom scores and the incidence of adverse events. Results Of the 36 men, 33 (92%) remained on study medication a t 6 months; the remaining three (8%) discontinued because of asthenia. After 3 months of treatment, the peak urinary now rate increased sign ificantly (P < 0.008) for both doxazosin (+3.7 mL/s) and terazosin (+3 .2 mL/s). The American Urological Association symptom score improved s ignificantly (P < 0.01) with both alpha blockers after 3 months of tre atment and efficacy was maintained at 6 months. There were small, non- significant decreases in blood pressure in patients receiving doxazosi n or terazosin, but no differences between patients who were normotens ive at baseline and those whose blood pressure was controlled by other anti-hypertensive drugs. Conclusion These results suggest that alpha blockade with either doxazosin or terazosin is well tolerated and effe ctive in older men with symptomatic BPH. Furthermore, patients on conc omitant antihypertensive medication need no alteration of their therap eutic regimen before the initiation of alpha blockade for BPH.