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An open randomized comparative trial of setegis (terazosine) has shown good subjective and objective results in patients with chronic bacterial prostatitis. The drug is well tolerated and produces insignificant side effects. It is also demonstrated that combined therapy with alpha-adrenoblockers is more effective that monotherapy with antibacterial drugs in patients with bacterial prostatitis.

Terasosine study covered 36 females aged 61 to 76 years (mean age 70.1 +/- 0.5 years) with hyperactive urinary bladder (HAUB). Thirty patients received alpha1-adrenoblocker terasosine (setegis) in a dose 1 mg twice a day for 2 months, 6 females were given placebo. At baseline, in 1 and 2 months the patients self-estimated urination, urine incontinence, imperative voiding, quality of life, discomfort, treatment satisfaction. Two months of therapy reduced imperative voiding by 70%, number of episodes of ugent incontinence by 90%. Capacity of the bladder increased by 30%. The patients reported improved condition of their bladder, 3 times lower discomfort because of imperative symptoms, satisfaction with treatment reached 71%. Patients of the placebo group noticed no significant positive trend in the above parameters. 43% patients with maximal improvement and cure of urine incontinence had good long-term results.

The aim of the study was assessment of clinical efficacy and safety of terazosine (setegis) in patients with benign prostatic hyperplasia (BPH) and concomitant cardiovascular disease. A total of 62 BPH patients with cardiovascular disease (ischemic heart disease, hypertension) having indications for alpha-adrenoblockers (mean age 74 +/- 11 years, 58-85) received terazosine in a dose 1-5 mg for 2 months. Clinical efficacy of terazosine was assessed by IPSS scale, residual urine, maximal voiding velocity. Safety of the drug was controlled by monitoring of arterial pressure, ECG, echo-CG. All the tests were made before therapy, on the treatment week 2, 4 and 8. The response was 90.3%. Overall symptoms score decreased by 37.0%, quality of life score rose by 23.8%. Amount of residual urine fell by 64.8%, maximal voiding velocity increased by 36.6%. Moderate effects of the drug (vertigo, weakness) occurred in 11.3% patients for 1 or 2 days after start of the therapy and were due to a moderate fall of arterial pressure in normotensive patients. Later artertial pressure stabilized, ECG registered no exacerbations of ischemic heart disease, no anginal attacks, no change in cardiac rhythm. Thus, terazosine (setegis) is effective and safe in BPH patients with cardiovascular disease. Pretreatment consultation of the cardiologist is desirable for correction of basic antianginal therapy.

Data are reported of changes of the intracardiac hemodynamics, systolic and diastolic cardiac function and their interrelations in the course of treatment of 34 hypertensive patients with adverzuten. Results indicate that the systolic and diastolic cardiac functions did not deteriorate and that reduction of postload was associated with their favourable changes.

The efficacy and safety of nadolol (N), propranolol (PP), prazosin (PS) and a diuretic (D) were studied and compared with the aid of a total systems approach in a cooperative open study with participation of 10 centers of the USSR. As many as 419 men suffering from arterial hypertension (diastolic AP 95 mm Hg) were entered into the study. After randomization the patients received one of the 4 drugs. In case the monotherapy failed, combinations of 2-3 drugs were administered. The treatment lasted one year, with a monthly control being exercised. The patients' from the study accounted for 15% including the final points which constituted 1.9%. Of these, 6 patients suffered myocardial infarctions (one with a fatal outcome) and 2 presented with cerebral circulatory disorders. 3.8% of the patients were withdrawn from the study because of the side effects of the drugs. Out of 356 patients who completed the studies, 36.8% received one, 43% two, and 20.2% three drugs by the end of the year. The protocol of the study and the results of the monotherapy were provided in Communication I. Combined therapy with two or three drugs was effective whatever the combination and brought about a 12-16% decrease of diastolic AP. The negative chronotropic effect of N exceeded that of PP. The stable effect, t. e. the effect that lasted continuously over 6 months, was seen in less that half the patients treated for a year. Therefore, N is an effective, comparatively safe and long-acting beta-blocker. As for its efficacy, it does not yield to PP or PS and compares very favourably with D. The drug can successfully be used in long-term treatment of arterial hypertension.

The hypotensive effect and tolerance of a 2-3 week course treatment with pratsiol (n = 59) and apressin (n = 60) were studied in patients with stage II essential hypertension and symptomatic arterial hypertension requiring no special therapy (diastolic arterial pressure in the horisontal position being 95 mm Hg and over). Seven patients were treated with apressin and pratsiol for 14 days under blind cross-over conditions. When used along for 2-3 weeks, apressin and pratsiol induced a hypotensive effect in 53% and 75% of the patients (p less than 0.05), respectively. When used in conjunction with hydrochlorothiazide, the hypotensive effect of apressin was 85%, that of pratsiol 93%. The daily effective dose of apressin equalled 155 +/- 9.9 mg, of pratsiol 9.3 +/- 0.6 mg. Side-effects of apressin were observed 3 times as often as with pratsiol (79% and 27%, respectively; p less than 0.01). The rate of discontinuation of apressin for side-effects reached 35% of the patients, whereas in pratsiol treatment it was only 1.6%.

Central hemodynamic parameters were monitored by invasive procedures (pulmonary arterial catheterization), and prazosin kinetics following the administration of a single 5 mg dose were determined in 69 patients with subacute myocardial infarction, complicated by heart failure. The response to prazosin was dependent on pretreatment hemodynamic parameters and differed between patients with early and manifest heart failure. There was a correlation between the peaks of hemodynamic change and drug concentration.

Investigation of the hypotensive action of minipress, a drug belonging to the group of selective blockers of alpha 1-adrenoreceptors, shows its efficacy in 56.3 percent of patients with stage II essential hypertension. The side-effects were recorded in 16.6 percent of the patients. It is noted that application of minipress at a mean daily dose of 3.4 ml for a long time reduces the total peripheral vascular resistance without inducing any substantial changes in the stroke volume of the heart or in the pulse rate. At the same time minipress produces a beneficial effect on the microcirculatory blood flow.