Introduction: To determine the changes in plasma lipid levels in symptomatic benign prostatic hyperplasia (BPH) patients receiving terazosin treatment. Materials and Methods: The study included 99 patients with BPH aged 44–74 years. The patients were divided into 3 groups: in group 1 (n = 25) with baseline total cholesterol levels of >220 mg/dl, terazosin 5 mg/day was used; in group 2 (n = 56) with basal total cholesterol levels of < 220 mg/dl, terazosin 5 mg/day was used, and group 3 (n = 18) did not use terazosin and was defined as the control group. Plasma levels of total cholesterol, low-density lipoprotein, high-density lipoprotein and triglyceride were recorded, and the high-density lipoprotein to total cholesterol ratio was calculated at the beginning of the study and after 12 weeks. Results: The total cholesterol level decreased from the baseline level by 10.88% after 12 weeks (p < 0.05) in group 1. The decrease was observed in 22 of 25 patients (88%). In group 1, the mean plasma total cholesterol level decreased significantly (p < 0.05), but the decrease was not significant in group 2 and no change was observed in group 3. The mean plasma low-density lipoprotein level decreased significantly in group 1 (p < 0.05), but no change was observed in the other 2 groups. The mean plasma high-density lipoprotein level increased in group 1, whereas no change was observed in the other 2 groups. The mean plasma triglyceride level decreased significantly in groups 1 and 2 (p < 0.05), but no change was observed in group 3. The high-density lipoprotein to total cholesterol ratio increased significantly in group 1, but no change was observed in the other 2 groups. Conclusion: We suggest that terazosin may be a reasonable choice because of the beneficial effect on the lipid profile in older symptomatic BPH patients with a higher ratio of dyslipidemia.

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