PD39-09 STATIN DRUG USE AND RISK OF SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA (BPH): RESULTS FROM THE PROSTATE CANCER PREVENTION TRIAL

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology and Natural History1 Apr 2015PD39-09 STATIN DRUG USE AND RISK OF SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA (BPH): RESULTS FROM THE PROSTATE CANCER PREVENTION TRIAL Darshan Patel, James Hotaling, Jeremy Myers, William Brant, and Jeannette Schenk Darshan PatelDarshan Patel More articles by this author , James HotalingJames Hotaling More articles by this author , Jeremy MyersJeremy Myers More articles by this author , William BrantWilliam Brant More articles by this author , and Jeannette SchenkJeannette Schenk More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2404AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The underlying anti-inflammatory properties of statin medications have been hypothesized to potentially prevent the incidence and progression of BPH. However, it is unclear whether indications for statin therapy confound these associations. We sought to understand the relationship between statin drug use and risk of symptomatic BPH in the Prostate Cancer Prevention Trial (PCPT). METHODS Associations of statin use with BPH incidence were prospectively evaluated in the placebo arm of the PCPT (1992–2003). Statin use was assessed at baseline (current use) and every 3 months through open-ended questions regarding new medication use. Incident symptomatic BPH was defined as the first report of surgical (transurethral resection of prostate, balloon dilation, laser therapy, prostatectomy) or medical treatment (5-α-reductase inhibitors or selective α blockers), or sustained lower urinary tract symptoms (2 IPSS scores ≥15). Proportional hazards models using time-dependent statin use were used to estimate covariate-adjusted associations of use with symptomatic BPH risk. To evaluate potential confounding by indication, models accounted for medical conditions associated with statin use. RESULTS Of the 4,969 men at baseline without BPH, 1,346 (27.1%) reported ever using statins. Men reporting statin use during the trial were more likely to be white (94% vs. 92%, p=0.02), married (88% vs. 85%, p=0.04), have a history of smoking (67% vs. 65%, p=0.02), and using aspirin (49% vs. 37%, p<0.001). Diabetes, hypertension, hyperlipidemia, myocardial infarction, coronary artery disease, stroke, and all cardiovascular disease were associated with statin use (all p<0.001). Of these conditions, only stroke (HR: 1.43, CI: 1.03-2.00) and cardiovascular disease (HR: 1.35, CI: 1.11-1.63) were associated with an increased risk of incident BPH. In multivariate models adjusted for age, race, BMI, smoking status, regular aspirin use, and marital status, statin use was associated with a 41% increase in BPH risk (HR: 1.41, CI: 1.22-1.77). Additional adjustment for history of medical conditions associated with statin use and BPH risk (cardiovascular disease, stroke, diabetes, hypertension, hyperlipidemia) did not substantially affect the association between statin use and BPH risk (HR: 1.45, CI: 1.16-1.81). CONCLUSIONS Statin drug use may be associated with an increased risk of symptomatic BPH independent of medication conditions associated with statin therapy. However, residual confounding may impact this association. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e833 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Darshan Patel More articles by this author James Hotaling More articles by this author Jeremy Myers More articles by this author William Brant More articles by this author Jeannette Schenk More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...