The Orthostatic hypotension is not associated with the mild cognitive impairment in the patients taking the alpha-blocker with benign prostate hypertrophy

초록

Background & Objective : The alpha blocker is usually taken by the patients with benign prostate hypertrophy(BPH), but can cause the orthostatic hypotension(OH). Some reports suggested that OH might be associated with the mild cognitive impairment(MCI). However, the prevalence of OH and MCI in the patient with BPH remains still unclear. We investigated the prevalence of OH and MCI in the patients with BPH and also found whether there is the association between OH and MCI in them. Methods : From April 2011, we recruited the patients with BPH, who had taken the alpha-blocker over one year. The exclusion criteria were (1) younger than 65 years old, (2) the history of OH, stroke or dementia, (3) the patients could not take the head-up tilt table test or cognitive function test. After formal consents, all patients took the head-up tilt table test and the neuro- psychologic tests including MMSE and MOCA. Orthostatic hypotension was defined as a decrease of systolic blood pressure ≥20 mmHg or diastolic blood pressure ≥10 mmHg within 5 minutes of position change from supine to standing, on the head-up tilt table test. We found the prevalence of MCI (defined as MMSE score ≤26 or MOCA score≤23) and OH, and then compared the prevalence of MCI, according to the existence of OH. Result : Until July, 2012, 43 patients were recruited to this study. Among all patients (aged 69.6±7.5yrs), 26subjects(60.5%) had OH. The prevalence of MCI was 41.9 % on MMSE and 67.4% on MOCA. There is no difference in the prevalence of MCI between OH group and the control group( MMSE, 42.3% vs 41.2 %, P=0.94; MOCA 65.4% vs 70.6%, P=0.72). The patients with OH had the low body mass index(BMI) than the control group (23.6±2.6yrs vs 27.2±6.8yrs, P=0.04) Conclusions : The patients, taking the alpha blocker, had the high prevalence of MCI and OH. The OH did not seem to be associated with MCI. The further study is needed to find the cause of the high prevalence of MCI in the patients