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Relationship between benign prostatic hyperplasia and history of coronary artery disease in elderly men
K M Weisman1, G E Larijani, M R Goldstein
1Department of Surgery, Taylor Hospital, Ridley Park, Pennsylvania, USA.
Insights
Elderly men with benign prostatic hyperplasia (BPH) showed a higher frequency of coronary artery disease (CAD). This suggests a potential link between androgen-dependent conditions like BPH and atherosclerosis development.
Area of Science:
- Urology
- Cardiology
- Andrology
Background:
- Benign prostatic hyperplasia (BPH) is an androgen-dependent condition common in elderly men.
- Coronary artery disease (CAD) is a significant health concern in aging populations.
- The potential relationship between BPH and CAD has not been extensively studied.
Purpose of the Study:
- To investigate the association between the presence of benign prostatic hyperplasia (BPH) and coronary artery disease (CAD) in elderly men.
- To explore potential shared etiological factors, such as androgen dependency, in the development of both conditions.
Main Methods:
- A retrospective chart review was conducted on 702 elderly men aged 65-80 years.
- Data on coronary artery disease (CAD) history, risk factors, and serum prostate-specific antigen (PSA) levels were collected.
- Exclusion criteria included conditions or treatments that could affect PSA levels or lipid profiles.
Main Results:
- Serum prostate-specific antigen (PSA) levels positively correlated with prostatic volume in BPH.
- Men with BPH (PSA > 1.0 microg/L) had a significantly higher frequency of CAD (29%) compared to men without BPH (PSA < 1.0 pg/L) (9%) (p<0.03).
- No significant differences in other CAD risk factors like age, smoking, diabetes, or hypertension were observed between groups.
Conclusions:
- Smooth muscle proliferation, potentially androgen-dependent, may play a role in the pathogenesis of both atherosclerosis and BPH.
- Further prospective studies are warranted to explore the impact of antiandrogen therapies on atherosclerosis.
Study Objective:
To assess the relationship between the occurrence of benign prostatic hyperplasia (BPH), an androgen-dependent disease, and coronary artery disease (defined as history of coronary artery bypass grafting, coronary angioplasty, myocardial infarction) in elderly men.
Design:
Retrospective chart review.
Setting:
Urology practice.
Patients:
Seven hundred two elderly men aged 65-80 years.
Intervention:
The men's charts were reviewed for data pertaining to coronary artery disease, risk factors for coronary artery disease, and serum prostate-specific antigen (PSA) levels. Men who had medical conditions, pharmacologic interventions, or surgical procedures that could alter PSA, and those taking lipid-lowering agents were not included.
Measurements And Main Results:
PSA levels correlate positively with prostatic volume of BPH. In men with levels under 1.0 pg/L (no BPH) and over 1.0 microg/L (BPH present), the frequency of coronary artery disease was 9% and 29%, respectively (p<0.03). No significant differences were noted between groups in other accepted risk factors for coronary artery disease including age, smoking, diabetes mellitus, or hypertension.
Conclusion:
Smooth muscle proliferation is an important and possibly androgen-dependent step in the development of atherosclerosis and BPH. Prospective studies are required to assess the effect of antiandrogens on atherosclerosis.