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Updated: Aug 18, 2026
Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate (HoLEP).
Published on: March 6, 2018
Treatment of benign prostatic hyperplasia in hypertensive men
William B White1, Timothy Moon
1Section of Hypertension and Clinical Pharmacology, Center for Cardiology and Cardiovascular Biology, University of Connecticut School of Medicine, Farmington, CT 06030-3940, USA. wwhite@nso1.uchc.edu
Insights
As the aging US population grows, more individuals will have both benign prostatic hyperplasia and hypertension. Alpha1 blockers are not recommended as initial hypertension treatment and should be used cautiously in these patients.
Area of Science:
- Geriatric Medicine
- Pharmacology
- Urology
Background:
- The US population is aging, leading to a rise in elderly individuals with multiple health conditions.
- Benign prostatic hyperplasia (BPH) and hypertension (HTN) are common comorbidities in older adults.
- Optimal management of hypertension is crucial for reducing morbidity and mortality.
Purpose of the Study:
- To review current guidelines regarding the treatment of patients with both BPH and HTN.
- To highlight the implications of alpha1 blocker use in hypertensive and normotensive patients with BPH.
Main Methods:
- Review of current American Urologic Association (AUA) and Joint National Committee (JNC) guidelines.
- Analysis of evidence from outcome trials on alpha1 blockers for hypertension.
- Consideration of potential adverse events associated with alpha1 blockers.
Main Results:
- Alpha1 blockers are not recommended as first-line therapy for hypertension.
- Current guidelines advocate for independent treatment of BPH and HTN with appropriate agents.
- Clinicians must consider the blood pressure effects and potential adverse events of alpha1 blockers in BPH patients.
Conclusions:
- Treatment strategies for patients with concomitant BPH and HTN should be individualized.
- Alpha1 blockers require careful consideration due to their antihypertensive effects and potential side effects.
- Independent pharmacologic management for each condition is the preferred approach.
Abstract:
As the proportion of the US population over the age of 65 continues to rise, it is likely that the number of individuals with concomitant benign prostatic hyperplasia and hypertension will also increase. To reduce morbidity and mortality, it is important to treat patients with hypertension optimally. Evidence from outcome trials suggests that alpha1 blockers should not be used as first-line antihypertensive therapy. Although some clinicians previously recommended alpha1 blocker monotherapy for patients with both hypertension and benign prostatic hyperplasia, the most recent American Urologic Association and Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure guidelines recommend independent treatment with the most appropriate pharmacologic agents for each condition. When treating patients with benign prostatic hyperplasia, clinicians should be aware of the potential impacts that alpha1 blockers may have on blood pressure and potential adverse events in patients who are normotensive as well as in patients with treated hypertension.
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