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Benign prostatic hyperplasia and cardiovascular risk: a prospective study among Chinese men

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To examine the prospective association of BPH with subsequent risk of CVD, including heart disease and stroke.

Methods

We used data from China Health and Retirement Longitudinal Study of 5242 Chinese men aged 45 years or older. During a follow-up of 7 years, we identified 613 cases of non-fatal CVD, including 417 heart diseases and 254 strokes. Cox proportional hazards models yielded hazard ratios (HRs) relating BPH to CVD, heart disease, and stroke incidence.

Results

Overall, 8.1% of men reported a history of BPH diagnosed by physicians at baseline. As compared with men without a history of BPH, those reporting a history of BPH had an increased risk of developing CVD (multivariable-adjusted HR = 1.43 [1.12, 1.83], heart disease (1.35 [1.00, 1.83]), and stroke (1.50 [1.03, 2.19]). The subgroup analysis by age at baseline (< 60 vs. ≥ 60 years) showed that the associations appeared to be evident among men < 60 years, particularly for CVD (1.82 [1.24, 2.69]) and heart disease (1.72 [1.06, 2.79]). However, interaction tests suggested the associations were not significantly modified by age (P for interaction > 0.10 for all outcomes).

Conclusion

In Chinese men, BPH was associated with higher risks of CVD, heart disease and stroke, particularly among men aged < 60 years.

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Availability of data and materials

The data are publicly available which can be downloaded at http://charls.pku.edu.cn/index/zh-cn.html.

Code availability

The code is available after request from the authors.

Abbreviations

CHARLS:

China Health and Retirement Longitudinal Study

BPH:

Benign prostatic hyperplasia

LUTS:

Lower urinary tract symptoms

CVD:

Cardiovascular disease

BMI:

Body mass index

HRs:

Hazard ratios

CIs:

Confidence intervals

ED:

Erectile dysfunction

References

  1. Roehrborn CG (2005) Benign prostatic hyperplasia: an overview. Rev Urol 7(Suppl 9):S3

    PubMed  PubMed Central  Google Scholar 

  2. McVary KT, Roehrborn CG, Avins AL et al (2011) Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol 185(5):1793–1803

    Article  Google Scholar 

  3. Gacci M, Corona G, Sebastianelli A et al (2016) Male lower urinary tract symptoms and cardiovascular events: a systematic review and meta-analysis. Eur Urol 70(5):788–796. https://doi.org/10.1016/j.eururo.2016.07.007

    Article  PubMed  Google Scholar 

  4. Madersbacher S, Sampson N, Culig Z (2019) Pathophysiology of Benign prostatic hyperplasia and benign prostatic enlargement: a mini-review. Gerontology 65(5):458–464. https://doi.org/10.1159/000496289

    Article  CAS  PubMed  Google Scholar 

  5. Russo GI, Castelli T, Privitera S et al (2015) Increase of Framingham cardiovascular disease risk score is associated with severity of lower urinary tract symptoms. BJU Int 116(5):791–796. https://doi.org/10.1111/bju.13053

    Article  PubMed  Google Scholar 

  6. Guven EO, Selvi I, Karaismailoglu E (2019) Association between benign prostate enlargement-related storage and voiding symptoms and systolic blood pressure: a single-center cross-sectional study. Sao Paulo Med J 137(5):446–453. https://doi.org/10.1590/1516-3180.2018.0543.R3.160919

    Article  PubMed  Google Scholar 

  7. Khandelwal GK, Sharma R (2017) Correlation between Benign prostatic hyperplasia and coronary artery disease. Int J Sci Study 5(5):191–196

    Google Scholar 

  8. Hu WS, Lin CL (2018) Increased risk of atrial fibrillation in patients with benign prostatic hyperplasia: a population-based cohort study. Clin Cardiol 41(10):1374–1378. https://doi.org/10.1002/clc.23063

    Article  PubMed  PubMed Central  Google Scholar 

  9. Wehrberger C, Temml C, Gutjahr G et al (2011) Is there an association between lower urinary tract symptoms and cardiovascular risk in men? A cross sectional and longitudinal analysis. Urology 78(5):1063–1067. https://doi.org/10.1016/j.urology.2011.05.065

    Article  PubMed  Google Scholar 

  10. Bouwman II, Blanker MH, Schouten BW et al (2015) Are lower urinary tract symptoms associated with cardiovascular disease in the Dutch general population? Results from the Krimpen study. World J Urol 33(5):669–676. https://doi.org/10.1007/s00345-014-1398-y

    Article  PubMed  Google Scholar 

  11. Zhao Y, Hu Y, Smith JP, Strauss J, Yang G (2014) Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS). Int J Epidemiol 43(1):61–68. https://doi.org/10.1093/ije/dys203

    Article  PubMed  Google Scholar 

  12. Lian Y, Yang L, Gao M, Jia CX (2021) Relationship of Frailty Markers and Socioeconomic Status to Incidence of Depressive Symptoms in a Community Cohort. J Am Med Dir Assoc 22(3):570–576. https://doi.org/10.1016/j.jamda.2020.08.026

    Article  PubMed  Google Scholar 

  13. Ribal MJ (2013) The link between benign prostatic hyperplasia and inflammation. Eur Urol Suppl 12(5):103–109

    Article  Google Scholar 

  14. Corona G, Vignozzi L, Rastrelli G, Lotti F, Cipriani S, Maggi M (2014) Benign prostatic hyperplasia: a new metabolic disease of the aging male and its correlation with sexual dysfunctions. Int J Endocrinol 2014:329456. https://doi.org/10.1155/2014/329456

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Gandaglia G, Briganti A, Gontero P et al (2013) The role of chronic prostatic inflammation in the pathogenesis and progression of benign prostatic hyperplasia (BPH). BJU Int 112(4):432–441. https://doi.org/10.1111/bju.12118

    Article  PubMed  Google Scholar 

  16. O’Connor JC, McCusker RH, Strle K, Johnson RW, Dantzer R, Kelley KW (2008) Regulation of IGF-I function by proinflammatory cytokines: at the interface of immunology and endocrinology. Cell Immunol 252(1–2):91–110. https://doi.org/10.1016/j.cellimm.2007.09.010

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Torimoto K, Matsumoto Y, Gotoh D et al (2018) Overactive bladder induces transient hypertension. BMC Res Notes 11(1):196. https://doi.org/10.1186/s13104-018-3317-6

    Article  PubMed  PubMed Central  Google Scholar 

  18. Karatas OF, Bayrak O, Cimentepe E, Unal D (2010) An insidious risk factor for cardiovascular disease: benign prostatic hyperplasia. Int J Cardiol 144(3):452. https://doi.org/10.1016/j.ijcard.2009.03.099

    Article  PubMed  Google Scholar 

  19. Birder LA, Van Kerrebroeck PEV (2019) Pathophysiological mechanisms of nocturia and nocturnal polyuria: the contribution of cellular function, the urinary bladder urothelium, and circadian rhythm. Urology 133S:14–23. https://doi.org/10.1016/j.urology.2019.07.020

    Article  PubMed  Google Scholar 

  20. Calogero AE, Burgio G, Condorelli RA, Cannarella R, La Vignera S (2019) Epidemiology and risk factors of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction. Aging Male 22(1):12–19. https://doi.org/10.1080/13685538.2018.1434772

    Article  PubMed  Google Scholar 

  21. Ma C, Su H, Li H (2020) Global research trends on prostate diseases and erectile dysfunction: a bibliometric and visualized study. Front Oncol 10:627891. https://doi.org/10.3389/fonc.2020.627891

    Article  PubMed  Google Scholar 

  22. Dong JY, Zhang YH, Qin LQ (2011) Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies. J Am Coll Cardiol 58(13):1378–1385. https://doi.org/10.1016/j.jacc.2011.06.024

    Article  PubMed  Google Scholar 

  23. Lu S-H, Chen C-S (2014) Natural history and epidemiology of benign prostatic hyperplasia. Formosan J Surg 47(6):207–210

    Article  Google Scholar 

  24. Yuan X, Liu T, Wu L, Zou ZY, Li C (2015) Validity of self-reported diabetes among middle-aged and older Chinese adults: the China Health and Retirement Longitudinal Study. BMJ Open 5(4):e006633. https://doi.org/10.1136/bmjopen-2014-006633

    Article  PubMed  PubMed Central  Google Scholar 

  25. St Sauver JL, Hagen PT, Cha SS et al (2005) Agreement between patient reports of cardiovascular disease and patient medical records. Mayo Clin Proc 80(2):203–210. https://doi.org/10.4065/80.2.203

    Article  PubMed  Google Scholar 

  26. Baykam MM, Aktas BK, Bulut S et al (2015) Association between prostatic resistive index and cardiovascular risk factors in patients with benign prostatic hyperplasia. Kaohsiung J Med Sci 31(4):194–198. https://doi.org/10.1016/j.kjms.2014.12.008

    Article  PubMed  Google Scholar 

  27. Ali D, Niemeijer M, Banerjee P (2012) Urinary retention and heart failure: One of the many precipitating causes of decompensation. Int J Cardiol 154(2):e38–e39. https://doi.org/10.1016/j.ijcard.2011.05.095

    Article  PubMed  Google Scholar 

  28. Tsai HK, D’Amico AV, Sadetsky N, Chen M-H, Carroll PR (2007) Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality. J Natl Cancer Inst 99(20):1516–1524. https://doi.org/10.1093/jnci/djm168

    Article  PubMed  Google Scholar 

  29. Bouwman II, Kollen BJ, van der Meer K, Nijman RJ, van der Heide WK (2014) Are lower urinary tract symptoms in men associated with cardiovascular diseases in a primary care population: a registry study. BMC Fam Pract 15:9. https://doi.org/10.1186/1471-2296-15-9

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We would like to thank all the participants in the CHARLS study and the National School of Development of Peking University for providing the data.

Funding

CHARLS study was supported by the National Institute on Aging of the National Institute of Health (nos. R01-AG037031-01, R01AG037031-03S1, R03-TW008358-01, and R21-AG031372- 01), the Natural Science Foundation of China (nos. 70910107022, and 71130002), and the Knowledge for Change Program at the World Bank (no. 7159234). The sponsors had no roles in study design, data collection, analysis, and interpretation, or manuscript writing, submitting and publication.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China

    Xiaowen Wang & Yonghua Hu

  2. Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, 5650871, Japan

    Xiaowen Wang & Jia-Yi Dong

  3. Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450002, China

    Yang Su

  4. Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, 100034, China

    Chao Yang

Authors
  1. Xiaowen Wang
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  2. Yang Su
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  3. Chao Yang
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  4. Yonghua Hu
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  5. Jia-Yi Dong
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Contributions

XWW and J-YD: Project development, Data analysis. XWW: Manuscript writing. All the authors: Results interpretation, Manuscript revision.

Corresponding author

Correspondence to Jia-Yi Dong.

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Ethics approval for CHARLS was obtained from the Biomedical Ethics Review Committee of Peking University (IRB00001052-11015).

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All the participants have completed written informed consent.

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Cite this article

Wang, X., Su, Y., Yang, C. et al. Benign prostatic hyperplasia and cardiovascular risk: a prospective study among Chinese men. World J Urol 40, 177–183 (2022). https://doi.org/10.1007/s00345-021-03817-z

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  • DOI: https://doi.org/10.1007/s00345-021-03817-z

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