Effects of terazosin therapy on blood pressure in men with benign prostatic hyperplasia concurrently treated with other antihypertensive medications

Objectives. To review and assess the cardiovascular safety of the alpha₁-blocker terazosin when used to treat symptomatic benign prostatic hyperplasia (BPH) in patients taking concurrent antihypertensive medications. Methods. This retrospective analysis focused on blood pressure changes and blood pressure-related side effects in 555 of 2084 patients randomized to either terazosin or placebo in the Hytrin Community Assessment Trial (HYCAT) study who were following either single or combination antihypertensive regimens (treated patients). We also compared results in normotensive and hypertensive patients, whether treated or not. Results. The addition of terazosin lowered mean systolic blood pressure by 5.3 mm Hg for untreated patients and 6.7 mm Hg for treated patients. For patients hypertensive on entry, mean reductions in systolic blood pressure in those untreated and treated were 12.1 and 11.1 mm Hg, respectively. The addition of terazosin to an existing antihypertensive regimen had its greatest impact (a mean reduction of 12.3 mm Hg) in those receiving diuretic therapy alone. Diastolic pressure changes followed a similar pattern. The incidences of blood pressure-related side effects in patients on terazosin were comparable between untreated (13.5%) and treated patients (14.3%), as were premature withdrawal rates, with 4.2% of untreated patients and 4.5% of treated patients withdrawing due to blood pressure-related side effects. Conclusions. Terazosin can be safely used to treat patients with symptomatic BPH regardless of their blood pressure status and antihypertensive regimen. Terazosin may be safely added to ongoing antihypertensive therapy.