Key result
Tamsulosin linked to ~11% lower nocturnal systolic blood pressure load without altering mean ambulatory levels.
Why the study?
The effects of alpha-1 adrenergic receptor antagonists on blood pressure patterns remain incompletely characterized.
Does tamsulosin reduce nocturnal blood pressure load in male patients with BPH-related LUTS?
Observational (n=58)
No
Does tamsulosin reduce nocturnal blood pressure load in male patients with BPH-related LUTS?
Effect estimate: absolute change -10.9 percentage points
Absolute Event Rate: 53.8% vs 64.7%
p-value: p=0.035
Tamsulosin does not significantly alter mean ambulatory blood pressure but may reduce nocturnal blood pressure load and minimum diastolic blood pressure, highlighting a potential risk for early hypotensive episodes.
May reduce nocturnal BP load without altering mean ambulatory values in BPH; observational data leave effects on dipping and outcomes open.
Background: Alpha-1 adrenergic receptor antagonists are widely used in the management of benign prostatic hyperplasia (BPH) . Their effects on blood pressure (BP) patterns remain incompletely characterized. This study aimed to prospectively evaluate the impact of tamsulosin on ambulatory blood pressure monitoring (ABPM) parameters, with particular focus on nocturnal BP load and dipping status. Methods: A total of 83 male patients aged 40–90 years who were initiated on tamsulosin for BPH-related lower urinary tract symptoms (LUTS) were prospectively enrolled; 58 patients with complete, technically adequate paired recordings were included in the final analysis. Participants underwent 24 h ABPM before treatment and at 1 month. Dipping status was defined as a nocturnal BP reduction ≥10%. Pre-post treatment ABPM parameters were compared using paired statistical analyses, and changes in dipping status were evaluated using McNemar’s test. Results: Mean 24 h, daytime, and nighttime systolic and diastolic blood pressure (DBP) values did not change significantly after treatment (p > 0.05). However, nocturnal systolic and DBP load decreased significantly following tamsulosin initiation (p = 0.035 and p = 0.005, respectively), along with a reduction in minimum DBP (p < 0.001). Changes in dipping status were heterogeneous: 25% of baseline non-dippers converted to a dipper pattern, whereas 36.4% of initial dippers became non-dippers, with no statistically significant overall shift (p = 0.81). Conclusions: At one month, tamsulosin was not associated with significant changes in mean ambulatory BP. Reductions in nocturnal BP load were observed, but the incremental clinical significance of BP load beyond mean ambulatory BP indices is uncertain. The marked decrease in minimum DBP warrants cautious interpretation as a potential safety signal. These findings should be considered exploratory and require confirmation in controlled studies incorporating earlier and longer follow-up.
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Yeşildal et al. (2026) conducted an observational in Benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS) (n=58). Tamsulosin vs. Baseline (pre-treatment) was evaluated on Nighttime systolic blood pressure load (absolute change -10.9 percentage points, p=0.035). Tamsulosin significantly reduced nocturnal systolic and diastolic blood pressure load and minimum diastolic blood pressure at one month, without significantly changing mean 24-hour, daytime, or nighttime ambulatory blood pressure.
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