Comparison of Effects of Alpha Receptor Blockers on Endothelial Functions and Coagulation Parameters in Patients with Benign Prostatic Hyperplasia

OBJECTIVE To investigate the effects of alpha receptor blockers used in the treatment of benign prostatic hyperplasia (BPH) on endothelial functions, coagulation parameters, and arterial blood pressure. MATERIALS AND METHODS One-hundred fifteen patients admitted to the treatment protocol because of symptomatic BPH were included in this prospective study. Patients were given the following treatments: doxazosin 4 mg/d (n = 25), terazosin 5 mg/d (n = 26), alfuzosin 10 mg/d (n = 26), tamsulosin 0.4 mg/d (n = 21), and observation (n = 17). All cases were evaluated before treatment and in the 12th week of treatment, according to biochemical parameters, endothelial functions, and arterial blood pressure. Biochemical parameters were bleeding time, coagulation time, prothrombin time, activated partial thromboplastin time, total prostate-specific antigen (PSA), and free PSA. Endothelial functions were evaluated with ultrasonography of the brachial artery. RESULTS When coagulation tests were evaluated, there were significant increases in bleeding and coagulation times in the groups using doxazosin and terazosin. Doxazosin and terazosin lowered arterial blood pressure significantly compared with other treatments. With regard to effects on endothelial function, there were significant differences in flow-mediated dilation rates of the brachial artery at 60 and 90 seconds before and during treatment in the alfuzosin and terazosin groups. CONCLUSIONS Alpha receptor blockers can decrease the risk of cardiovascular complications by both reducing platelet aggregation and protecting endothelial functions in patients with prostatic hyperplasia. The only drug with a favorable effect in all 4 areas of interest, including BPH symptoms, blood pressure, platelet aggregation, and endothelial functions, was terazosin. UROLOGY 77: 1439-1443, 2011. (C) 2011 Elsevier Inc.