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Finasteride provides relief of symptoms related to benign prostatic hyperplasia.

Finasteride, when compared to placebo and active comparators, improves long‐term urinary tract symptoms associated with benign prostatic hyperplasia.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Benign enlarged prostate: Medication and herbal products

Most men who have prostate problems either wait a while to see how their symptoms develop, or take medication. Medication is often used when the symptoms are not bad enough for surgery to be needed, but have become too bothersome to be left untreated.This might be the case if you have to go to the bathroom several times a night, or constantly feel the need to urinate during the day too because your bladder no longer empties properly. These typical symptoms of an enlarged prostate can become a real burden.Several types of medications and combinations of medications are available for the relief of problems associated with an enlarged prostate. Like with any medication, it is important to carefully consider the advantages and disadvantages of these medications, and be aware of possible interactions between different medications. The majority of men with an enlarged prostate are over the age of 50, and often on other medications too, like drugs for high blood pressure (hypertension).For instance, if a man is taking alpha blockers for the treatment of prostate problems, he should not use impotence drugs as well. This is because both of these medications have a blood-pressure-lowering effect, so his blood pressure could become too low otherwise.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: January 15, 2014

Alpha blocker treatment for men to increase chances to have urinary catheter successfully removed

Acute urinary retention in men is a medical emergency characterised by the sudden and often painful inability to pass urine. There are many known causes including prostate obstruction (because of enlargement of the prostate or cancer), urethral strictures (a narrowing of the urethra due to scar tissue), urine infection, constipation and neurological conditions. A narrow drainage tube (urinary catheter) is temporarily inserted into the bladder through the penis to allow drainage of urine. Once the catheter is removed, some men fail to pass urine again and need to be re‐catheterised. In these men, continued use of catheters or prostate surgery are the standard treatment options. Catheters are associated with risks such as infection and can harm quality of life. Measures for increasing the rate of successful catheter removal, that is, enabling patients to urinate spontaneously again, are therefore potentially beneficial. Alpha blockers (for example tamsulosin, alfuzosin) are a group of drugs known to have positive effects on urinary symptoms such as poor urinary flow. It is believed that their relaxing effect on the prostate may also increase the chance to void again after catheter removal. This review evaluated the evidence available to support this practice.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Alpha blockers have a modest BP lowering effect

The class of drugs called alpha blockers is sometimes used to lower elevated blood pressure. This class includes drugs such as doxazosin (brand name: Cardura), prazosin (Minipress) and terazosin (Hytrin). We asked how much this class of drugs lowers blood pressure and whether there is a difference between individual drugs within the class. The available scientific literature was searched to find all the trials that had assessed this question. We found only 10 trials studying the blood pressure lowering ability of 4 different alpha blockers in 1175 participants. The blood pressure lowering effect was modest. There was an 8‐point reduction in the upper number that signifies the systolic pressure and a 5‐point reduction in the lower number that signifies the diastolic pressure. No alpha blocker drug appears to be any better or worse than others in terms of blood pressure lowering ability. Due to incomplete reporting of the number of participants who dropped out of the trials due to adverse drug reactions, as well as the short duration of these trials, this review could not provide an estimate of the harms associated with this class of drugs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Treatment of high blood pressure for people with peripheral arterial disease

When blood pressure is consistently high it can lead to complications such as a heart attack (myocardial infarction) or stroke. Both peripheral arterial disease (PAD), a condition that affects the blood vessels (arteries) carrying the blood to the legs, arms, and stomach area, and high blood pressure (hypertension) are associated with atherosclerosis. This is hardening of the arteries which is caused by deposits of fat, cholesterol and other substances inside the blood vessels. PAD is diagnosed when the blood supply to the legs is restricted causing pain and cramping that limits walking (intermittent claudication). It is measured by the walking distance (on a treadmill) before onset of pain (claudication distance) or ankle brachial index (ABI), the ratio of the blood pressure in the arms to the blood pressure in the legs. If the blood pressure is lower in the legs compared to the arms (ABI of less than 1.0) this indicates blocked arteries in the legs (or PAD). PAD can progress to pain at rest and critical limb ischaemia (sudden lack of blood flow to a limb caused by a blood clot or fatty deposit blockage) that requires revascularisation (restoring the blood flow by opening up the blocked blood vessel) or amputation. Treatment of hypertension to reduce cardiovascular events (heart attack or stroke) and death needs careful consideration in people with PAD. Anti‐hypertensive medications may worsen the PAD symptoms by further reducing blood flow and supply of oxygen to the limbs, and may have long‐term effects on disease progression. The evidence from randomised controlled trials (RCTs) examining the risks and benefits of various anti‐hypertensive drugs on measures of PAD is lacking.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Systematic Reviews in PubMed

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Systematic Review Methods in PubMed

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