Use of 5αRI does not increase cardiovascular risk in men with BPH

Treatment with five-alpha reductase inhibitors (5αRIs) does not appear to elevate the risk of hospitalization for heart failure (HF), myocardial infarction (MI), stroke, or cardiovascular death among men with benign prostatic hyperplasia (BPH), a study has shown.

A group of researchers conducted this population-based cohort study among patients with a new diagnosis of BPH using the Clinical Practice Research Datalink containing hospitalization and vital statistics data. Exposure was defined as the current use of 5αRIs, current of alpha-blockers, and no current use of BPH medications in a time-varying approach.

The researchers estimated the adjusted hazard ratios (HRs) using time-dependent Cox proportional hazards models. Hospitalization for HF served as the primary endpoint, while MI, stroke, and cardiovascular death were secondary ones.

Overall, 94,440 men with incident BPH were included in the analysis, with a total of 3,893 HF hospitalization occurring over 527,660 person-years of follow-up (incidence rate, 7.38, 95 percent confidence interval [CI], 7.15‒7.61).

Current use of 5αRIs did not contribute to an increased risk of hospitalization for HF (HR, 0.94, 95 percent CI, 0.86‒1.03), MI (HR, 0.92, 95 percent CI, 0.81‒1.05), stroke (HR, 0.94, 95 percent CI, 0.85‒1.05), or cardiovascular death (HR, 0.89, 95 percent CI, 0.80‒0.99) compared with nonuse of BPH medications.

“The use of 5αRIs was not associated with an increased risk of hospitalization for HF, MI, stroke, or cardiovascular death compared with nonuse,” the researchers said.