SynthesisBMC geriatrics2022
Efficacy and safety of adrenergic alpha-1 receptor antagonists in older adults: a systematic review and meta-analysis supporting the development of recommendations to reduce potentially inappropriate prescribing.
Synthesis in BMC geriatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Doxazosin versus tamsulosin for the treatment of male lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH): systematic literature review and network meta-analysis.World journal of urology · 2026Pooled it
- Effect of Tamsulosin on Nocturnal Blood Pressure Load and Dipping Status: A Prospective Ambulatory Blood Pressure Monitoring Study.Journal of clinical medicine · 2026Article
- Isosorbide dinitrate as an effective adjunct therapy for acute urinary retention: A randomized controlled trial.BJUI compass · 2026Article
- Present and Future Options for Pharmacotherapy in Cardiovascular Disease: Hemodynamic and Mechanistic Therapeutic Targets.Medical sciences (Basel, Switzerland) · 2026Review
- Norepinephrine triggers ovarian granulosa cell ferroptosis via αJournal of ovarian research · 2026Article
- Increased Risk of Recurrent Ischemic Stroke in Male Patients Taking Medications for Benign Prostatic Hyperplasia.Life (Basel, Switzerland) · 2026Article
- Total Synthesis of Aporphine Alkaloids via Photocatalytic Oxidative Phenol Coupling and Biological Evaluation at the Serotonin 5-HTJournal of medicinal chemistry · 2025Article
- Investigating the impact of age and sex on cataract surgery complications and outcomes.Scientific reports · 2025Article
- Association between alpha blocker use and the risk of fractures in patients with chronic kidney disease: a cohort study.BMC nephrology · 2024Article
- Tamsulosin and Dutasteride Combination Therapy for Asian Men With Moderate-to-Severe Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: A Systematic Review of Clinical Considerations That Influence the Prescription.Journal of clinical medicine research · 2024Review
- Article
- Link between circadian rhythm and benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS).The Prostate · 2024Review
- Benign Prostatic Hyperplasia and the Risk of Falls in Older Men: Insights From a Population-Based Study on Geriatric Morbid Conditions.International neurourology journal · 2024Article
- Centrally acting antihypertensives and alpha-blockers in people at risk of falls: therapeutic dilemmas-a clinical review.European geriatric medicine · 2023Review
- Serenoa repens for the treatment of lower urinary tract symptoms due to benign prostatic enlargement.The Cochrane database of systematic reviews · 2023Review
- Comparison of primary care prescriptions for old and very old hypertensive patients.Turkish journal of medical sciences · 2023Article
- αInternational journal of molecular sciences · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdrenergic alpha-1 receptor antagonists (alpha-1 antagonists) are frequently used medications in the management of lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) and in the management of therapy-resistant arterial hypertension, two conditions frequently found in older adults. This systematic review aims at presenting a complete overview of evidence over the benefits and risks of alpha-1 antagonist treatment in people ≥ 65 years, and at deriving recommendations for a safe application of alpha-1 antagonists in older adults from the evidence found.
methodsA comprehensive literature search was performed (last update March 25
resultsEighteen studies were included: 3 meta-analyses, 6 randomised controlled trials and 9 observational trials. Doxazosin in the management of arterial hypertension was associated with a higher risk of cardiovascular disease, particularly heart failure, than chlorthalidone. Regarding treatment of LUTS suggestive of BPH, alpha-1 antagonists appeared to be effective in the relief of urinary symptoms and improvement of quality of life. They seemed to be less effective in preventing disease progression. Analyses of the risk profile indicated an increase in vasodilation related adverse events and sexual adverse events for some agents. The risk of falls and fractures as well as the effects of long-term treatment remained unclear. All meta-analyses and 5 out of 6 interventional studies were downgraded in the quality appraisal. 7 out of 9 observational studies were of good quality.
conclusionsIt cannot be recommended to use doxazosin as first-line antihypertensive agent neither in older adults nor in younger patients. In the management of BPH alpha-1 antagonists promise to effectively relieve urinary symptoms with uncertainty regarding their efficacy in preventing long-term progression events.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.