The association between alpha-blockers in the treatment of BPH and heart failure: A nationwide population-based cohort study in South Korea.

Background and objectives: This study aimed to determine whether there is an association between the use of α-blockers to treat benign prostatic hyperplasia (BPH) and the development of heart failure in elderly Asian patients.

Materials and methods: An Elderly Cohort Database of the National Health Insurance Service was used to select 22,540 patients with newly diagnosed BPH between January 1, 2008, and December 31, 2018. They were divided into two equal groups, one prescribed α-blockers and one not. They were followed up through December 31, 2019. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for the occurrence of heart failure with α-blockers. In addition, α-blockers were categorized according to α1a receptor selectivity to estimate the hazard ratios for heart failure.

Results: Heart failure occurred in 283 patients in the non-user group and 74 patients in the α-blocker group, with an incidence rate of 553.4 in the non-user group and 516.8 in the α-blocker group per 100,000 person-years. Although α-blocker users had a higher hazard ratio for heart failure compared to the non-user group, this was not statistically significant (HR: α-blocker HR 1.14, 95% CI 0.87 - 1.491). Furthermore, when α-blockers were stratified by selectivity, the results were also not statistically significant (non-selective α-blocker HR 0.86, 95% CI 0.31 - 2.36).

Conclusion: In this nationwide, population-based cohort study, treatment with α-blockers was not associated with the incidence of heart failure in patients with BPH.