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Association Between Alpha-Blockers for Benign Prostatic Hyperplasia and Acute Angle-Closure Glaucoma
Sung Uk Baek1, Su Hwan Kim2, Ahnul Ha3
1From the Department of Ophthalmology (S.U.B.), Hallym University Sacred Heart Hospital, Anyang, Korea; Department of Ophthalmology and Visual Sciences (S.U.B.), Dalhousie University, Halifax, Nova Scotia, Canada.
American Journal of Ophthalmology
|November 15, 2025
Summary
Alpha-blocker use for benign prostatic hyperplasia (BPH) significantly increases the risk of acute angle-closure glaucoma (AACG). The risk escalates with longer medication duration, highlighting the need for ophthalmologic evaluation.
Area of Science:
- Ophthalmology
- Pharmacology
- Urology
Background:
- Benign prostatic hyperplasia (BPH) is a common condition in aging men.
- Alpha-blockers are frequently prescribed for BPH symptoms.
- Acute angle-closure glaucoma (AACG) is a serious ocular condition that can lead to vision loss.
Purpose of the Study:
- To investigate the association between alpha (α)-blocker use for BPH and the incidence of AACG.
- To determine if the duration of α-blocker use impacts AACG risk.
Main Methods:
- Retrospective nationwide population-based cohort study using Korean National Health Insurance data (2002-2022).
- 1:5 propensity score-matched cohort created for 30,450 participants (5,075 AACG cases, 25,375 controls).
- α-blocker use for BPH identified via diagnosis and prescription records; categorized by cumulative medication duration (≤23 days, 24-202 days, ≥203 days).
Main Results:
- α-blocker use was significantly associated with an increased risk of AACG (adjusted HR, 1.52; 95% CI, 1.40-1.66).
- A dose-response relationship was observed: AACG incidence increased with longer α-blocker exposure duration.
- Incidence ranged from 0.15% for ≤23 days to 0.41% for ≥203 days of use.
Conclusions:
- α-blocker use for BPH is linked to a significant, duration-dependent increase in AACG risk.
- Ophthalmologic evaluation is recommended when prescribing α-blockers, especially for patients at risk for angle-closure events.
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