Indicated in the treatment of benign prostatic hyperplasia, alpha-blockers significantly increase the risk of developing heart failure, a study reveals.
- Taking alpha-blockers, indicated in the treatment of benign prostatic hyperplasia, can increase the risk of heart failure by up to 22%.
- If the statistical probability is significant, the absolute risk of developing heart failure is low in the absence of other risk factors.
- You should therefore not interrupt your treatment and discuss it with your doctor.
Common in men from the age of 50, benign prostatic hyperplasia (BPH) occurs when the prostate becomes too large and interferes with the emission of urine. It is then generally treated with two types of drugs: 5-alpha-reductase inhibitors which reduce the volume of the prostate and alpha-blockers (AB) which relax the smooth muscles.
The latter would however be involved in the increased risk of heart failure, estimates a new study published in the Journal of Urology. According to its authors, the risk would be higher in men taking BAs rather than 5-alpha reductase inhibitors (5-ARI). “Although no one should stop taking their BPH medications based on these results, our study provides new evidence for understanding the complex interplay of factors affecting heart disease risk in men with BPH.”explains Dr. Siemens of Queen’s University, Ontario (Canada).
A 22% increase in risk
To better understand the link between BPH drugs and heart failure, researchers used Ontario health data to identify more than 175,000 men with benign prostatic hyperplasia. About 55,000 patients were treated with BAs alone, 8,000 with 5-ARIs alone, and 41,000 with a combination of BAs and 5-ARIs. The others were not taking either type of BPH medication.
After analyzing follow-up data, the researchers found that the risk of developing heart failure was 22% higher in men taking BAs alone, 16% in those taking combination therapy, and 9% in those taking of 5-ARIs alone, compared to the control group of men not taking BPH medications.
The risk of heart failure was above all higher with the taking of old so-called “non-selective” alpha-blockers compared to new “selective” ABs. It was also higher in men taking BAs for a prolonged period: 14 months or more.
A real but low risk
However, the researchers want to be reassuring with men taking this type of medication: the increased probability of developing heart failure is statistically high, but the absolute risk remains relatively low. Additionally, risk factors such as previous heart disease, high blood pressure, and diabetes have a much greater impact on heart failure risk than BPH medications.
Men with benign prostatic hyperplasia should therefore continue to take their medications even though it is important that doctors, “including primary care physicians and urologists”are aware of this risk and inform “patients who have already suffered from heart disease or who have cardiovascular risk factors”.
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