Investigation Of Benign Prostatic Hyperplasia In Hypertensive Population And Efficacy Of Therapy With Amlodipine And Terazosin For Overactive Bladder Associated With BPH.

Objective : To investigate the distribution of benign prostatic hyperplasia (BPH) and overactive bladder(OAB) and the risk factors for BPH in hypertensive populations in rural community. To evaluate the efficacy of combined therapy with amlodipine and terazosin for middle-aged and old patients of overactive bladder (OAB) associated with BPH.Methods: This time the chosen subjects were from the research project whose object was to compare the efficacy and safety of treating hypertension by using amlodipine and terazosin respectively and combined therapy. A population-based epidemiological investigation was conducted to collect 621 hypertensive male patients over 50 years old who are local residents in Anqing ,Anhui. The 621 research subjects were divided into five groups randomly by using randomized, prospective, parallel study.Group one:5mg amlodipine;Group two:1mg terazosin;group three:2mg terazosin;group four:5mg amlodipine plus 1mg terazosin;group five: 5mg amlodipine plus 2mg terazosin. The subjects should continuously take the designated medicine before meals every day for four weeks, and 569 patients finished the 28-day observation of the efficacy of the medicine. This research one chose 621 hypertensive male patients as its research subjects. Among those people 300 patients were diagnosed with BPH according to the standard of the BPH. We investigate the distribution of benign prostatic hyperplasia (BPH) and overactive bladder(OAB) and explore the risk factors for BPH in hypertensive populations in rural community.While research two chose 272 hypertensive patients being coincidental with BPH and having taken continuously the designated medicine four weeks as the research subjects.Patients were randomly took amlodipine, terazosin and amlodipine plus terazosin ,respectively. The IPSS,quality of life(Qol),maximal urinary flow rate(Qmax),average urinary flow rate(Qave), systolic blood pressure(Sbp), diastolic blood pressure(Dbp) and the other charistic were determined at baseline and 4 weeks of follow-ups as efficacy parameters.Results: (1)The prevalence rate of bph and irrigative symptoms score increase with the growth of the age.(2)As diastolic blood pressure increases, irrigative symptoms score increases.(3)The spearman correlation coefficient of the irrigative symptoms score and the quality of life is 0.62.(4)Logistic regression analysis showed that BPH was related to only five major risk factors: age(OR=1.077, 95% CI: 1.046～1.109), sexual intercourse frequence in 30 years old(OR=1.027,95% CI:1.004～1.051), monthly salt intake(OR=2.007,95%CI:1.324～3.043),weekly fruits intake(OR=0.628,95%CI:0.431～0.914),tensity(OR=2.128,95%CI:1.439～3.146). (5)All three groups were efficacious for overactive bladder.The improvements of nocturia in the terazosin group were significantly greater than the other groups. The improvements of frequency and urgency in the terazosin group were significantly worse than the other groups.(6)No statictical differences have been found in three groups for the efficacy of OAB(P>0.05).Conclusion : (1) Overactive bladder is positively interrelated to the age and diastolic blood pressure.(2) Overactive bladder is the main factor which influences the quality of life of the patients with BHP.(3)Age, high sexual intercourse frequence in 30 years old, high salt intake,tensity were possible risk factors for BPH, while heavy fruits intake was possible protective factor.(4) The combination of amlodipine and terazosin is not superior to the use of amlodipine or terazosin individually in the treatment of OAB associated with BPH in the middle-aged and old patients although the three groups all have efficacy.