Profile of doxazosin in the hypertensive man with benign prostatic hyperplasia

A number of studies have confirmed the beneficial effects of selective alpha 1-adrenoceptor inhibitors in patients with benign prostatic hyperplasia (BPH). Most produce clinically significant improvements in symptom scores and uroflow, although some of the shorter-acting agents often do so at the expense of adverse events. Doxazosin has a slower onset of action and longer plasma half-life than any other available selective alpha 1-adrenoceptor inhibitor, which may confer advantages in terms of tolerability over the more rapidly absorbed and eliminated selective alpha 1-adrenoceptor inhibitors. Doxazosin produces statistically significant increases in mean and maximum uroflow, as well as small but significant reductions in maximum voiding pressures and statistically significant improvements in symptoms of frequency, urgency, nocturia, reduced uroflow and sensation of incomplete emptying. Changes in uroflow and symptoms are similar in normotensive and hypertensive patients with BPH, and are accompanied in hypertensive patients by a statistically significant fall in blood pressure. Treatment is well tolerated in both normotensive and hypertensive patients. Doxazosin, by virtue of its unique pharmacological profile, is a valuable new treatment option for the many patients with mild to moderate bladder outflow obstruction due to BPH. It may be especially appropriate therapy for those considerable numbers of elderly men who have both hypertension and bladder outflow obstruction due to prostatic enlargement.