enalapril and Prostatic-Hyperplasia

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).. 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.. 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.. 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.

Topics: Adrenergic alpha-1 Receptor Antagonists; Aged; Antihypertensive Agents; Carvedilol; Cross-Over Studies; Drug Therapy, Combination; Enalapril; Humans; Hypertension; Male; Middle Aged; Pilot Projects; Prazosin; Prostatic Hyperplasia; Single-Blind Method

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.

Topics: Aged; Antihypertensive Agents; Blood Pressure; Carbazoles; Carvedilol; Cross-Over Studies; Double-Blind Method; Enalapril; Humans; Hypertension; Male; Middle Aged; Propanolamines; Prostate-Specific Antigen; Prostatic Hyperplasia; Prostatism; Severity of Illness Index; Surveys and Questionnaires; Urodynamics

The androgen nandrolone decanoate (ND) is known to cause cardiovascular abnormalities, such as attenuation of the Bezold-Jarisch Reflex (BJR), cardiac hypertrophy, and elevation of mean arterial pressure (MAP). Futhermore, a relationship between androgens and the renin-angiotensin system (RAS) has been reported. The purpose of this study was to evaluate the influence of RAS on the BJR, cardiac and prostatic hypertrophy, and MAP evoked by ND. For this, male Wistar rats were treated with ND (10 mg·(kg body mass)(-1) for 8 weeks; DECA), or vehicle (control animals; CON), or enalapril (10 mg·(kg body mass)(-1), daily; CONE), or ND and enalapril (10 mg ND + 10 mg enalapril per kilogram of body mass; DECAE). After 8 weeks of treatment, the BJR was evaluated by bradycardia and hypotensive responses that were elicited by serotonin administration (2-32 µg·(kg body mass)(-1)). MAP was assessed; cardiac and prostate hypertrophy were determined by the ratio of the tissue mass:body mass, and by histological analysis of the heart. Animals from the DECA group showed prostatic and cardiac hypertrophy, elevation in mean arterial pressure, and an impairment of BJR. Co-treatment with enalapril inhibited these changes. The data from the present study suggest that RAS has an impact on BJR attenuation, cardiac and prostatic hypertrophy, and the elevation in MAP evoked by ND.

Topics: Anabolic Agents; Angiotensin-Converting Enzyme Inhibitors; Animals; Blood Pressure; Body Weight; Bradycardia; Cardiomegaly; Enalapril; Heart Rate; Male; Nandrolone; Nandrolone Decanoate; Prostatic Hyperplasia; Rats, Wistar; Renin-Angiotensin System