IPSS is lower in hypertensive patients treated with angiotensin-II receptor blocker: posthoc analyses of a lower urinary tract symptoms population.
OBJECTIVE
The existence of Angiotensin-II (Ang-II) receptors in the bladder wall and the pronounced contractile effect of Ang-II on the human detrusor muscle have been well established. Studies have presented the role of Ang-II as a mediator in smooth muscle growth and collagen production in the bladder with outlet obstruction. We investigated the associations between male lower urinary tract symptoms (LUTS) and hypertension (HT), and examined whether the medications used for HT treatment, particularly Ang-II receptor blockers (ARBs) influence LUTS.


METHODS
Among 4,298 men with LUTS who were nominated to participate in a Japanese study using the International Prostate Symptom Score (IPSS) to gain information on the effects and the safety of silodosin, a total of 3,790 men for whom a baseline IPSS was available were sub-analyzed. We analyzed the influence of HT treatment on IPSSs.


RESULTS
HT was the most common comorbidity (1,122 men, 29.6%), and 769 men (20.3%) were receiving some kinds of medication for the treatment. We found that the IPSS was lower in patients being treated for HT with ARB than in hypertensive patients who were not receiving any medication (16.8 ± 6.8 vs. 18.3 ± 6.6, P < 0.01). The baseline I-PSS in patients treated for HT with angiotensin converting enzyme inhibitor (ACE-I), calcium channel blocker (CCB), and normotensive patients were 18.3, 19.6, and 18.1, respectively.


CONCLUSIONS
The IPSS is lower in patients with HT treated with ARB. Other drugs for HT, including ACE-I and CCB, did not improve the IPSS.
Department of Urology, Faculty of Medical Science, University of Fukui, Fukui, Japan. uroito@u-fukui.ac.jp
Hideaki
H
Ito
Minekatsu
M
Taga
Katsuki
K
Tsuchiyama
Hironobu
H
Akino
Osamu
O
Yokoyama
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D007211:Indoles / Q000627:therapeutic use; D059411:Lower Urinary Tract Symptoms / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014554:Urination / Q000187:drug effects / Q000502:physiology
D000317:Adrenergic alpha-Antagonists; D057911:Angiotensin Receptor Antagonists; D007211:Indoles; C095285:silodosin