Study of the Association between Ischemic Heart Disease and Use of Alpha-Blockers and Finasteride Indicated for the Treatment of Benign Prostatic Hyperplasia

• Published in: European urology 2002-09, Vol.42 (3), p.254-261
• Main Authors: Souverein, P.C., Herings, R.M.C., Man in ‘t Veld, A.J., de la Rosette, J.J.M.C.H., Farmer, R.D.T., Leufkens, H.G.M.
• Format: Article
• Language: English
• Subjects: Adrenergic alpha-Antagonists - adverse effects; Adrenergic alpha-Antagonists - therapeutic use; Adult; Aged; Aged, 80 and over; Antineoplastic agents; Benign prostatic hyperplasia; Biological and medical sciences; Case-Control Studies; Chemotherapy; Cohort Studies; Enzyme Inhibitors - adverse effects; Enzyme Inhibitors - therapeutic use; Finasteride; Finasteride - adverse effects; Finasteride - therapeutic use; Hospitalization; Humans; Ischemic heart disease; Male; Medical sciences; Middle Aged; Myocardial Ischemia - chemically induced; Myocardial Ischemia - complications; Nested case control study; Pharmacology. Drug treatments; Prostatic Hyperplasia - complications; Prostatic Hyperplasia - drug therapy; α-adrenoceptor antagonists
• ISSN: 0302-2838; 1873-7560
• DOI: 10.1016/S0302-2838(02)00273-7

Objective: Given the high possibility of co-occurrence of benign prostatic hyperplasia (BPH) and cardiovascular disease, we evaluated whether patients using BPH drugs are at an increased risk of acute hospital admission for ischemic heart disease (IHD). Methods: A nested case control study within a cohort of 4414 men (aged ≥30 years) who had a history of using BPH products between 1992 and 1998 was conducted. Cases were defined as men with a first record of an acute hospital admission for IHD during the study period; three controls were matched to each case on year of birth, pharmacy and calendar time (index date). Results: The study population comprised 220 cases and 515 controls. Current use of alpha-blockers (adjusted odds ratio 1.0, 95% confidence interval: 0.5–2.2) or finasteride (adjusted odds ratio 0.3, 95% CI: 0.1–1.4) was not associated with hospital admission for IHD. Furthermore, current use of BPH drugs was not associated with IHD in patient subgroups (age, history of cardiovascular disease, diabetes), nor with duration of use prior to hospitalization. Conclusion: Although the power of the study was low, we found no evidence for an association between current use of BPH drugs and hospital admission for IHD. Therefore, our study seems to confirm the good cardiovascular safety profile of modern BPH drugs.