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The article presents the issues of the characteristics of the course, diagnostics and treatment of hyperactive urinary bubble in older men. Conservative treatment of urinary incontinence includes changes in lifestyle, behavioural and medical therapy with m-anticholinergic drugs. The combination solifenacini in a dose of 5 mg/day and α1-adrenoceptor blocking agent terasolini in a dose of 2 mg/day significantly improves the results of treatment and well tolerated.

The effects of chronic stress on the structure and function of the renal glomerular system were studied in hypertensive ISIAH rats treated with hypotensive drugs during the early ontogeny. The morphometric parameters of the renal glomerular system, characteristic of each of the experimental animal groups treated by enalapril, losartan, or terazosin in early age virtually did not change under conditions of stress exposure. These results indicate a persistent delayed nephroprotective effect of these drugs.

TUR of the prostatic gland for prostatic adenoma was made in 93 patients aged 54-81 years (mean age 64.4 +/- 7.5 years). The patients were divided into two groups. Patients of group 1 (n = 31) received no alpha-adrenoblockers, those of group 2 (n = 62) received terasosine in pre- and postoperative period. Group 2 patients demonstrated significant improvement in clinical parameters, postoperative hospital stay for them decreased by 11.3%, side effects were insignificant, their residual urine early after operation was 26.3 +/- 8.6 cm3 while 4 weeks after TUR it was 16.3 +/- 6.9 cm3. Thus, terasosine (setegis) can be recommended for use in early postoperative period after TUR of the prostate for prostatic adenoma as an effective and safe drug improving postoperative outcome.

Comparative morphometrical study of the renal glomerular system was carried out in hypertensive NISAG rats treated with hypotensive drugs during the prepubertal period. Blockade of the renin-angiotensin system with enalapril or losartan during the critical period of ontogeny (the 2nd month of life) produced a long-term hypotensive and renoprotective effect. Treatment with alpha-adrenoblocker terazosin during this period of ontogeny produced a less pronounced hypotensive effect, though with renoprotection. Corinfar (Ca2+ channel blocker) was least effective.

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.

A double-blind placebo-controlled trial of teraosin efficacy (Kornam, Lek, Slovenia) was made in 51 patients with chronic abacterial prostatitis/chronic pelvic pain syndrome (CAP/CPPS) of category IIla according to NIH. All the patients were given a 2-week induction course of placebo followed by teraosin treatment (5 mg/day, n = 29) or placebo (n = 22) for 8 weeks. The participants of the study were followed up for 12 months. Pretreatment differences between the groups by NIH-CPSI system, symptoms frequency scale, leukocyte count of the prostate and uroflowmetry were insignificant. Teraosin and placebo patients showed a noticeable improvement (39.7 and 9.9% by symptoms frequency scale, respectively; by 36.4 and 6.6% by the linear scale, respectively). The drug reduced pain and dysuria, improved quality of life considerably (by 36.2%). Maximal urine flow accelerated by 22.96 and 10.01% in teraosin and placebo groups, respectively. Leukocyte count fell two-fold in the study group and lowered insignificantly in the placebo group. The recurrence-free interval was 25 and 9 weeks, respectively. Thus, teraosin monotherapy improves quality of life in CAP/CPPS patients, significantly relieves symptoms and prolongs recurrence-free interval vs placebo.

Aim: To assess function of urinary retention and irritative symptoms from the lower urinary tracts in patients after radical prostatectomy for local prostatic cancer., Material and Methods: From November 1997 to May 2001 radical prostatectomy was performed in 181 patients. One year after the operation 86 patients with pT1c-T2b filled in the questionnaire on urinary retention (UR) and irritative symptoms., Results: One year after radical prostatectomy complete UR was registered in 76% of the patients, partial UR in 20.5% and unsatisfactory UR in 3.5%. Uroflowmetrical and ultrasound investigations, urine seeding made possible to select 16 patients with irritative symptoms. 11 patients of this group received alpha-adrenoblocker terazosin with a good response., Conclusion: One year after radical prostatectomy UR (complete or partial) was observed in 96.5% patients. Irritative symptoms unrelated to stricture of vesicourethral anastomosis and inflammation can be climinated by administration of terazosin.

Unlabelled: Alpha-adrenoblockers are commonly used to treat LUTS suggestive of benign prostatic hyperplasia in men. It is well known that they do not modify natural history of the disease but only relax the smooth muscle. Several investigations confirmed the presence of alpha 1-AR in the spinal cord, bladder neck, urethra and periurethral tissue in women (so-called female prostate). So, "prostatism-like" symptoms seem to be not gender-specific. Therefore, alpha-adrenoblockers may be used in the treatment of urinary disorders in women. 32 women (mean age 26.5 years, range 18-65) with functional BOO took a terazosin course after clinical and urodynamic examinations. The patients were divided into three groups: detrusor sphincter dyssinergia, primary bladder outlet obstruction and learned voiding dysfunction (dysfunctional voiding). Patients with urethral stricture, pelvic organ prolapse, bacteriuria were excluded. The initial dose was 1 mg/day, then it was increased to 5 mg/day. The treatment course lasted 2 months. Patients recorded the time and volume of every void three days before treatment and last three days of drug therapy. All the patients were satisfied with the results of the treatment. We noticed an increase in the maximal flow rate (55.4%), a decrease of delay time (48.9%) and nocturia (52.9%)., Conclusions: Specific agents, such as alpha-adrenoblockers, in low dosage may be effective in women with urinary tract disorders in case of careful and comprehensive evaluation of functional BOO.

Aim: To evaluate effectiveness and safety of terazosin vs tamsulosin in patients with benign prostatic hyperplasia (BPH); to elucidate effectiveness of the use of tamsulosin followed by terazosin and vice versa., Material and Methods: Group 1 of BPH patients received terazosin (5 mg/day) followed in a month by tamsulosin (0.4 mg/day). Group 2 received the same drug in the opposite sequence. The trial included 60 patients with symptoms of the lower urinary tracts due to BPH. The results were assessed on the treatment day 5-7, 14, 30 and 60 one month after the treatment termination., Results: Terazosin and tamsulosin relieved clinical symptoms, reduced QOL and Qmax. One month after the treatment the symptoms partially returned to baseline, Qmax returned completely. In cross-over, positive trends were weaker., Conclusion: Clinical efficiency of both drugs was comparable, there was no cross effect. A month interval between the treatments in this case was insufficient. This should be taken into account when planning further studies.

Aim: To evaluate effectiveness of alpha 1-adrenoblockers (a1-AB) in patients with chronic non-infectious prostatitis (CP)., Material and Methods: a1-AB effectiveness was studied in 28 volunteers with non-infectious CP (type IIIA). All the patients received terazosin (kornam, Slovenia) in a dose 5 mg/day after dose titration for 2-3 weeks (the initial dose was 1 mg/day). The assessment of the efficiency was standard with the use of frequency and severity of symptoms scales as well as questionnaire NIH CPSI., Results: Symptomatic improvement was achieved in 27 patients (96%). Dysuria and intensity of pain diminished in 24 (82%) and 26 (93%) patients. Voiding disorders proved most sensitive to a1-AB. Quality of life rose 2-fold. Probability of the recurrence 1 month after terazosin therapy was 0.29, after 6 months--0.43. Recurrent dysuria occurred in 33%, pain--in 58%., Conclusion: Terazosin monotherapy in patients with non-infectious CP results in reduction of the symptoms severity and pollakiuria frequency, frequency of recurrences and in improvement of quality of life. a1-AB in CP do not prevent recurrence in half the cases but the symptoms severity in recurrent disease is much weaker.

Results are submitted of investigations designed to study effects of prazosine on the clinical course, immune and lipid spectrum of blood plasma in IHD patients with functional class I-II middle-aged and elderly-onset exertional angina. Efficiency of prazosine monotherapy was recordable in all FC I-II effort angina patients 30 to 50 years old, which fact was manifested by a decline in the number of angina attacks over the 24-hour period, number and duration of both pain and symptom-free myocardial ischemia, improvement in physical load tolerance. Also recordable in all patients was a positive effect of the drug on blood plasma lipid spectrum and certain immunological indices.

Prazosin treatment effects were evaluated in two groups of patients with benign prostatic hyperplasia (BPH). 10 patients of group 1 have previously undergone epicystostomy for acute urine retention. They received prazosin for 7 days 5 mg/day. 9 patients of group 2 had no direct indications for adenomectomy and therefore received conservative treatment: one or two 3-week prazosin courses (5 mg/day). All the patients were examined before and after prazosin treatment. As shown by routine methods of investigation and rheocervicocystography, alpha-adrenoblockers, prazosin in particular, promote positive changes in cervical circulation of the bladder. This reduces detrusor hypoxia leading to bioenergetic normalization in the smooth muscles. Clinically, the response manifests in improved reservoir function of the bladder (increased effective volume, lowered pollakiuria). It is concluded that prazosin and other alpha-adrenoblockers are highly effective drugs in conservative treatment of BPH.

Guanfacine in analgesic doses of 2.0 and 4.0 mg/kg inhibits the background activity of the spinal cord posterior horn neurons and their responses to nociceptive stimulation of the receptive field in conscious rats. Naloxone (0.1 mg/kg) does not change, whereas prazosin and yohimbine (both on doses of 0.1 mg/kg) remove and partly relieve the depressant effect of guanfacine.

94 patients with obstructive urination due to benign prostatic hyperplasia received finasteride (proscar), inhibitor of 5 alpha-reductase, in a single dose 5 mg and terazosine, alpha 1 adrenoblocker, in a daily dose of 9.7 mg/day. The follow-up averaged 16.1 months. As shown by overall score of the symptoms and quality of life, rectal and ultrasonic examinations, uroflowmetry, the prostate decreased by 17%, on the average in 72% of the patients. Subjectively, urination has also improved. Maximal flow rate elevated by 55% in the majority of patients. Combination of finasterine with terazosine is well tolerated and proved optimal as a conservative therapy in patients with obstructive urination as a result of benign prostatic hyperplasia.

In patients with ischemic heart disease (IHD) with early coronary atherosclerosis the ratio of the myocardial ischemia pain episodes (MIPE) to myocardial ischemia pain-free episodes (MIPFE) is 1:4. In IHD patients, an important role to play in the development of MIPFE has the first segmental link in the analgetic system leading to a segmental rise of the electropain sensitivity threshold. Blockade of alpha 1-adrenoreceptors with prazosinum decreases the activity of analgesic mechanisms and favours transition from MIPFE to MIPE. In patients with the initial stages of coronary atherosclerosis, prazosinum promotes a significant alleviation of both MIPFE and MIPE.

Using two models of experimental thrombosis (arterio-venous shunt and Wessler's model) the effect of plasmin and its combination with alpha-adrenoreceptor antagonists on the formation of thrombus was studied on white rats. It was established that the efficacy of prophylactic of thrombosis by plasmin only was low: middle ball of thrombosis was 2.5-3.0. The combination of plasmin with alpha-adrenoblockers dihydroergotoxine or prazosin under these conditions is most efficient against the formation of thrombus (middle ball of thrombus in this case was 0.8-1.1). Prazosin under certain conditions have some advantages.

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.

Canine experiments have shown that prazosin used in the course of therapy for pulmonary hypertension and abolition of heart overload substantially enhanced myocardial contractility and relaxing properties of the both ventricles and improved cardiac pump function.

Graded isometric exercise (IE) testing was performed to study the effects of vasodilators from various classes on the hemodynamic response in 60 patients with mild and moderate essential hypertension (EH). Hemodynamic parameters were determined by rheography. Group I patients took captopril, 50 mg, Group II prazosin, 2 mg, and Group III nifedipine, 20 mg. Hemodynamic changes tended to deteriorate in patients with the EH syndrome during IET. Application of the vasodilators led to the alleviation of the changes both at rest and during IET, as manifested by lower absolute values of the parameters and their relative increase. The beneficial influences of drugs from various classes on some hemodynamic parameters were different.

The paper concerns a cooperative open study with participation of 10 centers of the USSR. After receiving placebo 419 men aged 30-59 years suffering from arterial hypertension (diastolic arterial pressure in the sitting position greater than or equal to 95 mm Hg) were given antihypertensive drugs after randomization. The treatment was provided in accordance with a stepped scheme and was started from monotherapy with the beta-adrenoblockers nadolol or propranolol (PP), or with the indirect vasodilator prazosin (PS) or the diuretic. If monotherapy failed, the patients were administered combinations of the indicated drugs. The treatment lasted one year, with a monthly control being exercised. 356 patients completed the studies. Of these, 131 patients (36.8%) had received monotherapy toward the end of the year. During the entire year, monotherapy was provided to 48.9% of the patients who started treatment from nadolol and completed the studies, to 34.1% who started treatment from PP, to 35.5% who started treatment from PS, and only to 14.4% of the patients who started treatment from the diuretic. Comparison of the patients' group given the diuretic with all the remaining groups demonstrate the difference to be significant. By the end of the treatment with nadolol, PP and PS, the diastolic arterial pressure reduced 10-11%, whereas toward the end of monotherapy with the diuretic, it dropped 6%, with the difference being significant. In patients on monotherapy, the negative chronotropic effect of nadolol exceeded that in patients given PP. Nadolol is an effective long-acting beta-blocker. By the intensity of the antihypertensive effect the drug is not inferior to PP or PS and compares very favourably with the diuretic.

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 study was undertaken to examine the effects of prazosin on clinical manifestations of the disease, hemodynamic parameters and myocardial contractility in 33 patients with coronary heart disease, postinfarction cardiosclerosis. The study was performed during an acute and chronic drug test. The efficiency of the therapy was checked by conventional clinical tools and examination of hemodynamic parameters and myocardial contractility from echocardiographic evidence. In the acute and chronic drug test, prazosin was found to cause a significant reduction in systemic and pulmonary pressures, total peripheral resistance and an improvement of total and regional myocardial contractility. Its two- or three-week therapy suffices to achieve the steady therapeutic effect of the drug.

The paper deals with the study into the benefits of prazosin and trasicor used in arterial hypertension. Their effects on the blood lipid composition were evaluated. With prazosin, the steady antihypertensive effect was reached in 81.0%, whereas with trasicor, it was attained in 46%. When prazosin was given, total cholesterol and triglycerides were statistically significantly decreased by 6.8 and 14.8%, respectively, while high density lipoproteins was increased by 9.1%. When trasicor was administered, no changes were observed in the spectrum of serum lipids. Thus, prazosin is effective in correcting two major risk factors for coronary heart disease, namely arterial hypertension and hyperlipoproteinemia, thereby reducing a risk for coronary heart disease.

A comparative study was undertaken to examine the long-acting beta-blocker nadolol without intrinsic sympathomimetic activity and reference agents such as anapriline, a beta-blocker, hypothiazide, a diuretic, and pratsiol, a postsynaptic alpha-adrenoblocker in 361 patients with sustained arterial hypertension (diastolic blood pressure, 95 mm Hg or more) in the randomized groups. The therapy was started with monotherapy of one of these drugs; if ineffective, a combination of two or, if necessary, three agents of different groups was given. The patients' status was monitored at least once monthly for 6 months. Monotherapy with beta-blockers or pratsiol was found to be more effective than that with diuretics. Addition of the second agent was required by 48% of the patients, that of the third agent, by 13%. Nadolol in combination with diuretics and/or pratsiol showed the same effects as did anapriline. The agent possessed a more pronounced negative chronotropic action than did anapriline when it was given alone or in combination. Nadolol caused a decrease in middle and small-sized bronchial patency as did anapriline. A 6-month nadolol therapy resulted in regression of left ventricular hypertrophy.

Arterial blood pressure and central hemodynamic changes were assessed in 44 patients with essential hypertension, uncontrollable by prazosin alone, after propranolol (anaprilin), celiprolol, clonidine (clofelin) or verapamil were added to the treatment schedule. A selective beta 1-adrenoblocker, celiprolol, is shown to be the best option in prazosin-treated patients with reflex increment of heart rate and stroke volume. The prazosin-verapamil combination is also justified in cases of moderately increased pulse rate, while propranolol and clonidine produce no additional hypotensive effect when combined with prazosin.

The efficacy of peripheral vasodilators with different action mechanisms was studied and compared in 96 patients with chronic circulatory failure, stages IIB-III, of different genesis (rheumatic fever, congestive cardiomyopathy, postinfarction cardiosclerosis). Isosorbide dinitrate was used in 16 patients, nitroglycerin in 36, pratsiol in 24, and captopryl in 20 patients. Monitoring of the ECG, heart rate, respiratory rate and arterial blood pressure as well as catheterization of the right heart and tetrapolar impedance plethysmography were performed. The parameters of the heart pre- and afterload, pulmonary hemodynamics as well as those characterizing myocardial contractility were measured. It was established that the successful use of the different vasodilators rests on an adequate determinations of the indications for use. Captopryl is particularly effective in grave circulatory failure associated with a dramatic activation of the renin-angiotensin system. Pratsiol is effective in all the cases of chronic CF, since the tone of the sympathoadrenal system is virtually always high in patients with grave decompensation. Pratsiol was particularly efficacious in chronic CF with mitral or aortal regurgitation.

Thirty-eight patients with stage IIB essential hypertension have been studied to determine the therapeutic activity of prazosine (pratsiol, "Orion" company, Finland) and its influence on the parameters of the central and peripheral hemodynamics. It has been established that following the oral administration of the drug, a hypotensive effect develops in 90-120 min and lasts for about six h. After a three-week course of treatment, the arterial pressure in the majority of patients decreased due to a reduction in the total peripheral resistance and the tone of the resistant vessels (arterioles). Simultaneously, there was an increase in the heart rate, end diastolic and stroke volumes and in the cardiac output. In a smaller portion of patients, the arterial pressure decreased due to the predominant reduction in the venous tone; the elasticity of the veins increased sharply, the end diastolic stroke and minute volumes diminished. The heart rate and total peripheral resistance showed no statistically significant changes. It has been established that pratsiol acts as an arterial and venous vasodilator and that it is advisable to use the drug in combination with beta-blockers and diuretics.

A comparative study of changes in plasma lipids, apo-A1 and apo-B under the effect of 2-week, 2-month and 6-month treatments with hydrochlorothiazide and pratsiol was conducted in 48 patients with arterial hypertension. Hydrochlorothiazide caused a significant increase in total cholesterol (CH), LDL cholesterol, apo-A1 and apo-B, and a decrease in cholesterol load of HDL particles as compared to placebo effects. Increased levels of HDL cholesterol were only noted in the early days of hydrochlorothiazide treatment. Pratsiol therapy produced a significant reduction of total triglycerides (TG), VLDL cholesterol, the cholesterol atherogenic coefficient, the apo-B/apo-A1 ratio, and increased HDL cholesterol. The activity of post-heparin lipoprotein lipase was not basically affected by hydrochlorothiazide, while pratsiol evoked a significant increase in its activity. The pratsiol-associated TG decrease was more pronounced in patients with elevated TG baseline, and the rise in HDL cholesterol, in those with initial hypo-alphacholesterolemia. Therefore unlike hydrochlorothiazide, pratsiol is associated with a favorable antiatherogenic trend of changes in the lipoprotein spectrum.

Eighty eight patients with ischemic heart disease were studied. There was a significant increase in pulmonary blood flow time (Tp), pulmonary blood volume (BVp). mean pulmonary pressure (MPP), and total pulmonary resistance (TPR). as regarded as initial signs of heart failure, in group 1 that comprised 35 patients out of 65 after a graded isometric loading test. After prazosin therapy, these patients showed a significant decrease in blood pressure, only moderate reduction in MPP and TPR, and a rise of the cardiac index (CI). There was a significant decrease in Tp, BVp, MPP, TPR during the loading test following the therapy. From group 2, 23 patients were treated with capoten. The monotherapy was beneficial in 9 patients, capoten was discontinued in 1 case; 13 patients received a combined therapy with glycosides and saluretics. In all the cases, a positive clinical and hemodynamic effect (lower blood pressure, total peripheral resistance, BVp, higher CI with virtually unchanged heart rate) was achieved.

Nine patients with renal insufficiency in the terminal stage, 6 with chronic diffuse glomerulonephritis and 3 with chronic pyelonephritis, underwent 402 sessions of programmed hemodialysis. All the patients had persistent high arterial hypertension, which did not yield to conventional medical treatment, complicating hemodialysis extremely, as the procedure produced a critical increase of arterial blood pressure (ABP). The patients were given new hypotensive drugs (minoxidyl, captopril, prazosine), which lowered ABP and permitted a reduction of hypotensive injections during hemodialysis. Three patients were subjected to bilateral nephrectomy, which also considerably facilitated hemodialysis in these patients.

The clinical effect of the peripheral vasodilator prazosin (Adwersuten, GDR) was studied in 51 patients with second-stage essential hypertension. A single dose of 1 to 2.5 mg produced hypotensive effect in 48 (94.1%) patients, that lasted between 3 and 4 hours, with the lowest ABP drop occurring 1.5-2.5 hours after the administration. When prazosin was given as a course of monotherapy, its daily dose varied between 3 and 20 mg (6.7 +/- 0.6 mg). A marked hypotensive effect was obtained by the end of the first week in 91.4% of patients. A 28.6% decrease in total peripheral resistance was the principal hemodynamic effect of prazosin. No significant changes of heart rate were recorded on the group basis, while side-effects were noted in 7 (13.7%) patients (orthostatic hypotension and allergic response).

Altogether 33 patients with arterial hypertension were investigated to study changes of left ventricular systolic phasic analysis, caused by prazosin therapy. Two groups were identified on the basis of these changes: indices in the 1st group (intrasystolic index, myocardial tension index, Blumberger coefficient) improved, in the 2nd group they deteriorated. The antihypertensive effect of prazosin should be assessed not only by the level of BP reduction but also by changes of left ventricular systolic phasic analysis. In the deterioration of indices of left ventricular systolic phasic analysis during a test with single administration of prazosin, antihypertensive therapy should be reconsidered.

A single dose of capoten (25 mg) and prazosin (I mg) was given to 82 patients with stable pulmonary hypertension and chronic non-specific pulmonary diseases and to 34 patients with the above condition and arterial hypertension. Systolic and diastolic pressure in the system of the pulmonary artery and total pulmonary and total peripheral resistance were decreased; capoten exhibited more pronounced hypotensive effect. Unidirectional changes were revealed in the course treatment. Combined use of capoten, prazosin and euphilline produced the additional hypotensive effect on pulmonary circulation. Capoten and prazosin had no direct broncholytic effect.

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.

An acute clinical experiment was carried out with 34 patients with chronic refractory cardiac insufficiency with stasis and idiopathic dilating (stasis) cardiomyopathy so as to follow up the hemodynamic effect of the vasodilators prazosin and erythrityl tetranitrate. The values of the central and peripheral vascular hemodynamics were followed up before and one hour after the peroral intake of 2 mg prazosin and half an hour after the peroral intake of 40 mg erythrityl tetranitrate. The results indicate that a statistically significant decrease of the arterial pressure and the total peripheral vascular resistance developed after prazosin intake. The systolic arterial pressure was decreased from 121,80 +/- 3,52 to 102,40 +/- 3,71 (p less than 0,001) and the diastolic--from 80,20 +/- 2,41 to 68,20 +/- 2,56 (p less than 0,01). The values of the total peripheral vascular resistance were decreased from 2629,65 +/- 174 to 1865,53 +/- 153 (p less than 0,001). The indices of the pump function--Stl and SI were increased (Stl from 22,74 +/- 1,85 to 30,37 +/- 2,14 with p less than 0,025 and Sl--from 1,90 +/- 0,08 to 2,64 +/- 0,19; p less than 0,02). The indices of the pressure in the left ventricular filling had no statistically significant change. After the administration of erythrityl tetranitrate, a statistically significant improvement of the indices of the cardiac output was also observed as well as of the total peripheral vascular resistance. The systolic index grew from 1,74 +/- 0,20 to 2,70 +/- 0,16 (p less than 0,01); stroke index--from 18,35 +/- 2,82 to 32,99 +/- 2,88 (p less than 0,01), and the total peripheral vascular resistance was decreased from 2897,0 +/- 186,0 to 1556,0 +/- 154,0 (p less than 0,001). Prazosin and erythrityl tetranitrate led to a considerable decrease of the counter load of the heart and improvement of the pump function of left ventricle in an acute experiment in case of chronic cardiac insufficiency with stasis.