Alfuzosin safe for older patients with cardiovascular disease

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Older age, cardiovascular comorbidity and the use of antihypertensive medication do not affect a patient’s tolerance of alfusozin, an alpha-1-blocker used to treat lower urinary tract symptoms (LUTS), according to an international group of researchers.

“The results confirm the efficacy and safety profile of alfuzosin as already demonstrated in phase III studies,” researchers led by Dr. Rudolph Hartung, from the Urology Clinic at the University of Munich in Germany, write in the Journal of Urology.

Alpha-1-blockers are a first-line treatment option for LUTS suggestive of benign prostatic obstruction. Because some of these compounds have recently been shown to differ in their cardiovascular safety profiles, the team assessed the use of alfuzosin in “real-life” practice.

The study included patients usually excluded from phase III studies because of their co-morbid conditions, according to the authors. However, “the physician is confronted with such patients in daily clinical practice and should be aware of the efficacy and safety of [alfuzosin] in such populations,” they note.

In all, 6,523 men were given open label alfuzosin (10 mg once daily) and followed for six months. After being divided by age quartile—younger than 60, 60 to 64, 65 to 70 and older than 70 years—outcomes were analyzed considering the patients’ co-morbidity with either hypertension, ischemic heart disease or diabetes, and eventual concomitant intake of antihypertensive agents.

The results show that the alfuzosin regimen was effective and well-tolerated. Despite the increased prevalence of cardiovascular co-morbidities and polypharmacy with age, the changes observed in blood pressure did not significantly differ among the age groups. In men with hypertension and those receiving hypertensive medication, changes in blood pressure and heart rate remained minor (less than 3mm Hg) compared to controls, according to the authors.

Results also showed that the percent of individuals who experienced adverse effects did not significantly differ by quartile: 23.9% of all patients experienced adverse events such as dizziness, and 3.5% experienced serious adverse effects.

J Urol 2006;175:624-628.

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