Influencing Factors Of Efficacy With Amlodipine, Terazosin And Its Combination Therapy On Low Urinary Tract Symptoms

Objective To analyse the influencing factors of efficacy with Amlodipine,Terazosin and their combination therapy on International Prostate Symptom Score and the effect of blood pressure control and lower urinary tract symptoms improvement on quality of life for hypertensive patients with lower urinary tract symptoms.Methods A randomized, double-blind,parallel-group clinical trail was conducted by the Biomedical Institute of Anhui Medical University(Anqing,Anhui,China) from July through October 2007. All patients were provided written informed consent before the trail. The eligible patients were defined as men≥50 years with Stage 1 or 2 essential hypertension (systolic blood pressure (SBP)≥140 mmHg but<180 mmHg and/or diastolic blood pressure (DBP)≥90 mmHg but<110 mmHg) and with International Prostate Symptom Score (IPSS)≥10. The exclusion criteria included a history of postural hypotension,secondary hypertension, prostate cancer, and prostate surgery or other intervention. 360 research subjects were divided into three groups randomly by using randomized, prospective, parallel study. Group one:5mg amlodipine;Group two:2mg terazosin;group three: 5mg amlodipine plus 2mg terazosin. The subjects should continuously take the designated medicine before meals every day for four weeks and demological, epidemiological and clinical data was collected and analyzed.Results (1): Age (OR=0.9 , 95%CI=0.4～1.9), body mass index (OR=2.3 ,95%CI=0.5～8.9), baseline blood pressure (OR=0.6,95%CI=0.3～1.3), baseline IPSS (OR=1.1,95%CI=0.5～2.5) and smoking(OR=0.9,95%CI=0.6～1.5) do not influence the efficacy of therapy with Terazosin on IPSS for hypertensive patients with lower urinary tract symptoms significantly(P>0.05). (2): Baseline blood pressure (OR=2.4,95%CI=1.0～5.5), baseline IPSS (OR=2.3,95%CI=1.0～5.4) influence the efficacy of therapy with Amlodipine on IPSS for hypertensive patients with lower urinary tract symptoms significantly(P<0.05). (3): Baseline IPSS (OR=2.9 , 95%CI=1.3～6.7) influence the efficacy of therapy with Amlodipine plus Terazosin on IPSS for hypertensive patients with lower urinary tract symptoms quite significantly(P<0.01). (4): There is a significant linear relationship between baseline IPSS and baseline QOL. (5): There is a significant correlation between IPSS improvement and QOL improvement in all groups but there is no significant correlation between SBP or DBP improvement and QOL improvement in any group. (6): There is an significant linear relationship between IPSS improvement and QOL improvement in all groups.Conclusion (1): Baseline blood pressure,baseline IPSS may be the main influencing factors of efficacy of therapy with Amlodipine for hypertensive patients with Lower urinary tract symptoms on IPSS, Amlodipine may be more effective in treating more serious hypertensive patients with more serious lower urinary tract symptoms. (2): Amlodipine plus Terazosin therapy may be even more effective in treating hypentensive patients with serious lower urinary tract symptoms. (3): Baseline QOL increases with Baseline IPSS in hypertensive patients with Lower urinary tract symptoms. (4): For hypertensive patients with Lower urinary tract symptoms, the improvement of QOL mainly depends on the improvement of IPSS. (5): To improve IPSS is of great importance to improve QOL for hypertensive patients with Lower urinary tract symptoms.