ADDITION OF DIURETIC EASES NOCTURIA?

NEW YORK (Reuters Health) Apr 21 - Hydrochlorothiazide combined with the alpha-blocker terazosin is effective in some men with nocturia who have failed to respond to terazosin monotherapy, according to Korean researchers.

"Hydrochlorothiazide may be an appropriate strategy in hypertensive patients with concomitant nocturia," senior investigator Dr. Jae-Seung Paick told Reuters Health, "since hydrochlorothiazide has efficacy for nocturia as well as few absolute contraindications and low cost."

In the March issue of Urology, Dr. Paick and colleagues at Seoul National University College of Medicine report on their study of 72 men who showed a <>

They went on to a further 4 weeks of daily treatment with 4 mg of terazosin and 25 mg of hydrochlorothiazide. "The patients were instructed to take the hydrochlorothiazide 8 hours before bedtime and the terazosin at bedtime," the team notes.

In all, only 53 of the men completed the study. There were no serious side effects and no dose reductions were required in any of the patients, the investigators report.

Fourteen patients had a reduction in nocturia score of 25% or more, 31 achieved a reduction of up to 24% and the remaining patients had an increased score.

Using a frequency-volume chart, 22 patients reported a reduction of 25% or more, and 31 reported no improvement or an increase in nocturia.

Polyuria resolved in 6 of the 51 patients who had such symptoms at baseline.

The researchers concede that the study had limitations including no tracking of blood pressure, something they suggest may be particularly important to do in elderly patients. These and other parameters should be monitored when combination therapy is employed.

Nevertheless, they conclude that the "findings suggest that the use of a diuretic agent, such as hydrochlorothiazide, might be a reasonable second-line treatment option for these patients, especially for those with nocturnal polyuria."