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Meds for Enlarged Prostate Tied to Heart Failure Risk

WEDNESDAY, March 17, 2021 -- Medications used for enlarged prostate are associated with a small, but significant, increase in developing heart failure, according to a study published online Feb. 22 in The Journal of Urology.

Avril Lusty, M.D., from Queen's University in Kingston, Ontario, Canada, and colleagues used administrative databases to identify 175,201 men older than 66 years with a diagnosis of benign prostatic hyperplasia (BPH) between 2005 and 2015. The primary outcome of new cardiac failure was compared for men with 5-alpha reductase inhibitor (5ARI) exposure and/or alpha-blocker (α-blocker) exposure.

The researchers identified 8,339 men exposed to 5ARI, 55,383 exposed to α-blockers, and 41,491 using combination therapy. There was a higher risk observed for cardiac failure among men treated with 5ARI and α-blocker, alone or in combination, versus men with no medication use. The risk for cardiac failure was highest for α-blockers alone (hazard ratio [HR], 1.22; 95 percent confidence interval [CI], 1.18 to 1.26), intermediate for combination α-blockers/5ARIs (HR, 1.16; 95 percent CI, 1.12 to 1.21), and lowest for 5ARI alone (HR, 1.09; 95 percent CI, 1.02 to 1.17). The risk for cardiac failure was higher for nonselective α-blockers than selective α-blockers (HR, 1.08; 95 percent CI, 1.00 to 1.17).

"This is an important finding, given that BPH is so common among older men, and that these medications are so widely used," a coauthor said in a statement.

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