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Fall risk related to subtype-specific alpha-antagonists for benign prostatic hyperplasia: a nationwide Korean population-based cohort study

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Abstract

Background

Subtype-specific alpha-antagonists are medications commonly prescribed for lower urinary-tract symptoms, benign prostatic hyperplasia in older populations. Our study aims to investigate the association between subtype-specific alpha-antagonists and fall risk.

Methods

A total of 4,202,739 men aged 60–75 years eligible for Korean Health Insurance Review and Assessment Service (HIRA) during 2017–2018 were enrolled retrospectively. After propensity score matching, 53,303 people in the exposed and unexposed groups were considered in the final study analysis.

Results

The subtype-specific alpha-antagonists significantly increased the risk of fall in the exposed cohort compared to the unexposed cohort (odds ratio [OR] 1.80; 95% confidence interval [CI] 1.62–2.00). Low income increased the fall risk only in the unexposed cohort (OR 1.34; 95% CI 1.04–1.73). A seasonal difference appeared only in the exposed cohort, with a significantly higher risk of fall in summer (OR 1.23; 95% CI 1.03–1.47). A total of 968 events occurred in the exposed group, and 455 of these falls occurred on the first day of medication (47%).

Conclusions

Subtype-specific alpha-antagonists significantly increased the risk of falls, especially on the first day of drug initiation and during the summer season. Education on orthostatic hypotension and fall prevention should be implemented when prescribing subtype-specific alpha-antagonists.

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Availability of data and materials

As this study is based on data from the National Health Insurance of Korea, the authors are not allowed to share data in raw form.

Abbreviations

LUTS:

Lower urinary-tract symptoms

BPH:

Benign prostatic hyperplasia

SSAAs:

Subtype-selective alpha-antagonists

HIRA:

Health Insurance Review and Assessment Service

NHIS:

National Health Insurance System

PSM:

Propensity score matching

ICD:

International classification diseases

OR:

Odds ratio

CI:

Confidence interval

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Funding

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Ministry of Science and ICT (MSIT) of South Korea (No. 2020R1F1A1072209). The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Author information

Author notes

  1. Jae-Hyun Seo and Jae Sang Han contributed equally to this work.

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Jae-Hyun Seo & Jae Sang Han

  2. Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-Gu, Seoul, 06591, Republic of Korea

    Yunhee Lee & U-Syn Ha

  3. Cancer Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Yunhee Lee & U-Syn Ha

  4. Department of Occupational and Environmental Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Jun-Pyo Myong

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  1. Jae-Hyun Seo
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  4. Jun-Pyo Myong
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Contributions

U-SH had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: All authors. Acquisition, analysis, or interpretation of data: J-HS, JSH, YL, U-SH. Drafting of the manuscript: J-HS, JSH. Critical revision of the manuscript for important intellectual content: U-SH. Statistical analysis: YL. Obtained funding: U-SH. Administrative, technical, or material support: YL, U-SH. Supervision: U-SH.

Corresponding author

Correspondence to U-Syn Ha.

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The authors declare that they have no competing interests.

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This study was approved by the Institutional Review Board of the Catholic University of Korea (KC21ZESI0096).

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Seo, JH., Han, J.S., Lee, Y. et al. Fall risk related to subtype-specific alpha-antagonists for benign prostatic hyperplasia: a nationwide Korean population-based cohort study. World J Urol 40, 3043–3048 (2022). https://doi.org/10.1007/s00345-022-04195-w

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  • DOI: https://doi.org/10.1007/s00345-022-04195-w

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