ABSTRACT
Resumen Introducción La hiperplasia prostática benigna es el padecimiento urológico más frecuente en hombres mayores de 50 años; sus síntomas afectan la calidad de vida. Los bloqueadores alfa-adrenérgicos son una opción para mejorarla. Objetivo Determinar la calidad de vida de pacientes con hiperplasia prostática benigna antes y después del tratamiento con un bloqueador alfa-adrenérgico. Material y métodos Estudio pretest-retest en hombres de 45 a 75 años con hiperplasia prostática benigna. Se administró tamsulosina (0.4 mg/día) por tres meses y se evaluó la severidad de los síntomas y la calidad de vida con el International Prostate Symptom Score (IPSS) y EuroQol 5-D. Se usaron X2 y prueba de rangos y signos de Wilcoxon. Resultados Se incluyeron 50 pacientes de 63.3 ± 10.3 años, 34 (68.0%) tenían síntomas severos antes del tratamiento y 19 (38.0%) después de tres meses (p < 0.05). Con el IPSS, 33 (66.0%) pacientes estaban en categorías de «tan insatisfecho como insatisfecho¼ a «muy insatisfecho¼ antes de la intervención y seis (12.0%) después de ella. La escala visual análoga (EVA) del EuroQol 5-D mostró puntuación basal de 72.9 ± 11.2 versus 83.4 ± 7.6 después (p < 0.05). Conclusión La tamsulosina reduce la severidad de los síntomas y mejora la calidad en de vida en la hiperplasia prostática benigna después de administrarla tres meses.
Abstract Introduction Benign prostatic hyperplasia is an urological disorder most common in men over 50 years old; the symptoms affect the quality of life. Alpha-adrenergic blockers are an option to improve it. Objective To determine the quality of life of patients with benign prostatic hyperplasia before and after treatment with an alphaadrenergic blocker. Material and methods Pretest-retest study in men of 45 to 75 years with benign prostatic hyperplasia. Tamsulosin was administered (0.4 mg/day) for three months; the severity of symptoms and quality of life were assessed with IPSS and EuroQol 5-D. Ranges and sign of Wilcoxon test and X2 were used. Results Fifty patients were included of 63.3 ± 10.3 years of age, 34 (68.0%) had severe symptoms before the treatment and 19 (38.0%) after three months (p < 0.05). With IPSS, 33 (66.0%) patients were in the categories of «as dissatisfied as unsatisfied¼ and «very dissatisfied¼ before the intervention and six (12.0%) after. The VAS of the EuroQol 5-D showed a baseline score of 72.9 ± 11.2 versus 83.4 ± 7.6 after (p < 0.05). Conclusion Tamsulosin reduces severity of symptoms and improves quality of life in benign prostatic hyperplasia after giving it three months.
ABSTRACT
Objetivo: Avaliar o efeito anti-hipertensivo e a tolerabilidade de dose única diária de cloridrato de prazosina de liberaçäo lenta (SR). Casuística e Métodos: 1393 portadores de hipertensäo arterial sistêmica primária (HAS) leve (644 pacientes e moderada (749 pacientes), com média etária de 47,63 anos, sendo 745 (53,52%) do sexo masculino, 1011 (72,84%) brancos e 279 (20,1%) negros. De acordo com protocolo multicêntrico aberto näo comparativo, os pacientes receberam cloridrato de prozosina SR em dose inicial de 1 mg, ajustada até máximo de 6 mg, de acordo com a resposta (objetivo = pressäo arterial diastólica (PAD) < ou = 90 mmHg), por prazo de 4 semanas. Resultados: A dose média diária foi de 2,08 mg, em tomada única. Ao final do estudo, 1274 (91,46%) pacientes atingiram PAD < ou = 90 mmHg, sendo 624 do grupo HAS leve e 650 do HAS moderada. O número de pacientes sob controle nas 3 primeiras semanas foi de 426 (1ª semana), 844 (2ª semana) e 1147 (3ª semana). APAD reduziu-se da média de 104 ñ 5 mmHg para a de 88 ñ 8 mmHg (p < 0,05). A freqüência cardíaca variou da média de 82 ñ 9 bpm pré-tratametno para 80 ñ 8 bpm na 4ª semana. Reaçöes adversas foram reconhecidas em 377 (27,06%) pacientes, total de 444 eventos, sendo mais freqüente a associaçäo de vertigem, tontura e lipotímia. Apenas 8 (2,12%) pacientes necessitaram reduzir as doses de cloridrato de prazosina SR e 5 (1,32%) tiveram de abandonar o estudo pelos efeitos indesejáveis da droga. Conclusäo: Cloridrato de prazosina SR em tomada única diária parece ser real avanço no tratamento da HAS leve e moderada, facilitando-o sem perda da eficácia e com boa tolerabilidade
Purpose: To evaluate the efficacy and tolerability of a single daily dose of sustained-release (SR) formulation of prazosin hydrocloride. Patients and Methods: 1393 outpatients in a multicenter open comparative trial. 644 patients had mild hypertension and 749 patients had moderate hypertension. The mean age was 47.63 years, 745 (53.52%) were male, 1011 (72.84%) white and 279 (20.1%) black. The patients received prazosin hydrocloride SR during 4 weeks in an initial dose of 1 mg, adjusted to a maximum of 6 mg in order to decrease the diastolic blood pressure (DBP) to 90 mmHg or less. Results: The mean daily dose was 2.08 mg. At the end of the study, 1274 (91.46%) patients had DBP £ 90 mmHg or less. 624 patients were in the mild hypertension group and 650 patients were in the moderate hypertension group. The number of patients under DBP control in the first three weeks was 426 (first week), 844 (second week) and 1147 (third week). The DBP decreased from the mean value of 104 ± 5 mmHg to 88 ± 8 mmHg (p < 0.05). The mean heart rate ranged from 82 ± 9 beats/min (pre-treatment) to 80 8 beats/min (fourth week). Adverse effects were identified in 377 (27.06%) patients, total of 444 episodes, the more frequent being dizziness. Only 8 (2.12%) patients had to reduce the doses of prazosin hydrocloride SR and 5 (1.32% ) had to discontinue the treatment on account of the adverse effects of the drug. Conclusion: Prazosin hydrocloride SR in a single daily dose seems to be an advance in the treatment of patients with mild and moderate hypertension.