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Cardiovascular and cerebrovascular outcomes of long-term angiotensin receptor blockade: meta-analyses of trials in essential hypertension.

2017-05-24

In an open multicenter prospective study, the effects of short-term (4 weeks, n = 101) and long-term (6 months, n = 38) terazosin treatment on blood pressure, serum lipids and safety in the patients with mild to moderate essential hypertension were observed. Mean systolic and diastolic blood pressure in sitting position were significantly reduced by 16.4% and 14.0% respectively (P < 0.01) after 4 weeks of terazosin therapy, with the total efficacy rate being 87.1%. During a 6 month therapy, antihypertensive effect of terazosin could be maintained. Total cholesterol (TC) and low density lipoprotein (LDL) cholesterol in serum were significantly decreased P < 0.05-0.01) in patients with hypercholesterolemia (TC > or = 6 mmol/ml) after 4 week terazosin treatment; the levels of TC, LDL and triglyceride were significantly improved in hypertensive patients after 3-6 month terazosin treatment. The improvement of lipid metabolism was related to the dosage of terazosin but not to antihypertensive effects of terazosin. The results suggested that terazosin is effective in decreasing blood pressure and improving lipid metabolism. It may serve as a good antihypertensive agent for hypertensive patients with hypercholesterolemia.

Terazosin is effective in the treatment of sympathetically maintained pain when given once daily because of a long elimination half-time and a long duration of action. This may encourage better patient compliance than do other alpha antagonists of shorter effective duration.

The aim of the study was assessment of clinical efficacy and safety of terazosine (setegis) in patients with benign prostatic hyperplasia (BPH) and concomitant cardiovascular disease. A total of 62 BPH patients with cardiovascular disease (ischemic heart disease, hypertension) having indications for alpha-adrenoblockers (mean age 74 +/- 11 years, 58-85) received terazosine in a dose 1-5 mg for 2 months. Clinical efficacy of terazosine was assessed by IPSS scale, residual urine, maximal voiding velocity. Safety of the drug was controlled by monitoring of arterial pressure, ECG, echo-CG. All the tests were made before therapy, on the treatment week 2, 4 and 8. The response was 90.3%. Overall symptoms score decreased by 37.0%, quality of life score rose by 23.8%. Amount of residual urine fell by 64.8%, maximal voiding velocity increased by 36.6%. Moderate effects of the drug (vertigo, weakness) occurred in 11.3% patients for 1 or 2 days after start of the therapy and were due to a moderate fall of arterial pressure in normotensive patients. Later artertial pressure stabilized, ECG registered no exacerbations of ischemic heart disease, no anginal attacks, no change in cardiac rhythm. Thus, terazosine (setegis) is effective and safe in BPH patients with cardiovascular disease. Pretreatment consultation of the cardiologist is desirable for correction of basic antianginal therapy.

The direct haemodynamic effects of terazosin can be characterized by an E(max) effect compartment model.

Throughout the study year, 193 different physicians wrote 341 prescriptions that matched the drug inclusion criteria for 210 different patients. The most frequently observed scenario involved the prescription for women of selective alpha-blockers, including alfuzosin hydrochloride, tamsulosin hydrochloride, and terazosin hydrochloride, that are indicated exclusively for the treatment of benign prostatic hyperplasia.

The results of this 4-week, double-blind, randomized trial have demonstrated that in Chinese male hypertensive patients with LUTS, low-dose Amlodipine plus terazosin therapy appears to be a safe and effective combination therapy to control both conditions, especially for those with predominant overactive bladder symptoms.

The following databases were searched from inception to 6 August 2013 for published and unpublished research evidence: MEDLINE; EMBASE; Cumulative Index to Nursing and Allied Health Literature; The Cochrane Library including the Cochrane Systematic Reviews Database, Cochrane Controlled Trials Register, Database of Abstracts of Reviews of Effects and the Health Technology Assessment database; ISI Web of Science, including Science Citation Index, and the Conference Proceedings Citation Index-Science. The US Food and Drug Administration website and the European Medicines Agency (EMA) website were also searched.

We retrospectively reviewed cases of TURP for LUTS due to bladder outlet obstruction from 1995 to 1998. The TURP patients in whom AA therapy had failed (group 1) were compared with those who had symptomatic BPH but were not taking AAs (group 2). Comorbid conditions that might influence treatment results were considered, as were sizes of resection and pathologic results.

Ophthalmology Section, Palermo University, Palermo, Italy.

The effects of terazosin, a new, selective, alpha 1-adrenoceptor antagonist, on the serum lipid levels were examined in 103 black patients with uncomplicated, mild to moderate essential hypertension in six randomized, double-blind, placebo-controlled trials conducted in the United States. Terazosin produced statistically significant (P less than 0.05) reductions in total serum cholesterol and triglyceride levels and a marginally significant (P = 0.080) reduction in the combined low-density lipoprotein (LDL-C) and very-low-density lipoprotein (VLDL-C) cholesterol fraction when compared with placebo. We conclude that terazosin, unlike thiazide diuretics, has a favourable effect on the serum lipid profiles of hypertensive blacks.