Epidemiology of benign prostatic hyperplasia: risk factors and concomitance with hypertension

Benign prostatic hyperplasia (BPH) is a common condition. Eighty-eight per cent of autopsy specimens from men aged over 80 years have been shown to have histological BPH. It is the cause of the commonest surgical procedure in older men (3 men in 10 may ultimately undergo prostatectomy). Despite its being such a common occurrence, little is known with any certainty about the epidemiology of BPH. The incidence, even the population prevalence, is difficult to determine for a variety of reasons. Knowledge of risk factors is sparse, and analytical epidemiological studies of BPH are difficult to conduct. Case-control studies are problematic, in that a control group may be difficult to define and a large proportion of the control group may have undiagnosed BPH. There have been reports of associations between BPH and hypertension, but there is no consistent suggestion that such an association could be causal. However, given the frequent occurrence of both conditions in ageing men, a large proportion of men may well have both diseases. With the increase in the number of men now reaching older ages it is clear that BPH, as well as hypertension, will continue to have a substantial and increasing influence in terms of morbidity, mortality and healthcare costs. The need for high-quality epidemiological information and consequent increased prospects for prevention is obvious.