Expanding role of alpha adrenoceptor blockade in the treatment of benign prostatic hyperplasia

This review analyses the expanding role of alpha adrenoceptor blockers in the treatment of BPH and examines the rationale for their use. The safety and efficacy of currently available alpha adrenoceptor blockers is reviewed, with emphasis on the most extensively studied agent, doxazosin. Like other alpha adrenoceptor blockers, doxazosin improves both symptoms of BPH and urinary flow rates by a statistically significant effect compared with placebo. Doxazosin also significantly reduces blood pressure in the 30% of BPH sufferers who also have hypertension; furthermore, there is a beneficial effect on lipid metabolism, which may translate into a reduced risk of coronary heart disease. It is concluded that existing alpha adrenoceptor blockers constitute a valuable adjunct to other BPH therapies, and further refinement of alpha adrenoceptor selectivity based on the alpha-1A subtype in the near future promises even better targeted alpha blockade.