Microwave treatments for enlarged prostate cause blood pressure surges

Many men who receive microwave therapy for enlarged prostates experience significant surges in blood pressure that could raise their risk of a heart attack or stroke, according to new research findings published recently in Mayo Clinic Proceedings.

The Mayo Clinic-led study of 185 consecutive patients who received transurethral microwave therapy at four medical centers found that 42 percent experienced systolic blood pressure surges of more than 30 mm Hg, while 5 percent had surges of more than 70 mm Hg.

“Men who are candidates for this minimally invasive microwave therapy tend also to be at higher risk for cardiac events,” says Lance Mynderse, M.D., the Mayo Clinic urologist who authored the study. “Blood pressure surges of the magnitude identified in this study are troubling side effects of treatment that need to be monitored and managed.”

Benign prostatic hyperplasia (BPH), or an enlarged prostate gland, is a condition affecting half of men over age 50 and 80 percent of those over 70. Symptoms include difficult urination, sudden urges to urinate and inability to empty the bladder. BPH often is treated with medication and in severe cases open surgery may be necessary, but since 1997 transurethral microwave therapy has been a less-invasive option.

Transurethral microwave therapy involves using a catheter to place a microwave device within the prostate, which is then heated to destroy excess tissue. Approximately 70,000 such procedures are performed each year, usually in an office setting and typically involving patients from 50 to 85 years old.

“This patient population is at high risk of cardiovascular disease,” explains Benjamin Larson, a medical student at Cleveland Clinic who is the lead author of the Mayo Clinic Proceedings paper. “Anecdotal reports of adverse blood pressure events during and after transurethral microwave therapy, and our own experience, led us to look back at the records to identify potential problems among these patients whose blood pressure had been monitored.”

The authors say the study findings should not necessarily deter physicians and their patients from using one of the six FDA-approved devices for transurethral microwave therapy, but they should take reasonable precautions given the strong possibility of blood pressure surges. “Blood pressure monitoring should be a standard part of the procedure. Blood pressure readings should be taken throughout the procedure, multiple times. Unfortunately, that has not always been the practice for this office-based therapy,” Dr. Mynderse explains. “Monitoring will enable physicians to identify the problem and adjust treatment. Patients also should be encouraged to continue their anti-hypertensive medications, particularly beta blockers, as they prepare for the procedure.”

Source: Mayo Clinic

Related stories:

Researchers use virtual reality to study complexities of dizziness
Think back to when you slipped on the ice or in the shower: the ground rushing up, your feet shooting out, terror building even as your mind is working a mile a second to plot a soft landing.
Study shows heavy snoring is an independent risk factor for carotid atherosclerosis
A study in the Sept. 1 issue of the journal Sleep shows that objectively measured heavy snoring is an independent risk factor for early carotid atherosclerosis, which may progress to be associated with stroke.
Will screening for cardiovascular problems be effective?
Last week the government in England closed its consultation on the effectiveness of vascular checks for high-risk individuals aged 40-74, to be rolled out in 2009-10, but will this strategy be worthwhile? Experts debate the issue on bmj.com today.
Report suggests allopurinol may lower blood pressure in teens with hypertension
The drug allopurinol, which lowers uric acid levels, appears to reduce blood pressure in adolescents with newly diagnosed hypertension, according to a preliminary report in the August 27 issue of JAMA.
High levels of uric acid may be associated with high blood pressure
Reducing levels of uric acid in blood lowered blood pressure to normal in most teens in a study designed to investigate a possible link between blood pressure and the chemical, a waste product of the body's normal metabolism, said researchers at Baylor College of Medicine in a report that appears in the current issue of the Journal of the American Medical Association.
Asthma monitoring on the Web
An inexpensive web-enabled device for measuring lung function in patients with asthma and other disorders is being developed by researchers at Texas Instruments, in Bangalore, India, and co-workers. Writing in the International Journal of Biomedical Engineering and Technology, the team explains how the devise could allow physicians to monitor their patients remotely and quickly instigate medical attention in an emergency.
Austrian health researcher may face fraud, criminal charges
An Austrian government report charges that clinical trials conducted by researchers at a major medical school in Austria were riddled with procedural and ethical problems, the Nature Publishing Group said Monday.
A therapy for baby boomers to sleep on
If you're over 55 and have spent more than a few sleepless nights, you're not alone -- insomnia affects about half of all people over 55 -- but you may also be at increased risk for physical and mental ailments.

News discussion:

Medicine & Health news