Benign prostatic hyperplasia/lower urinary tract symptoms and their impact on the recurrence of cardiovascular disease: a cohort study from the China Health and Retirement Longitudinal Study database
10.3760/cma.j.cn112330-20231120-00145
- VernacularTitle:良性前列腺增生/下尿路症状对心血管疾病复发的影响:一项来自中国健康与养老追踪调查数据库的队列研究
- Author:
Guorong YANG
1
;
Kaikai LYU
;
Yangyang WU
;
Qing YUAN
;
Tao SONG
Author Information
1. 解放军总医院第三医学中心泌尿外科医学部,北京 100039
- Publication Type:Journal Article
- Keywords:
Prostatic hyperplasia;
Lower urinary tract symptoms;
Cardiovascular disease;
Disease recurrence
- From:
Chinese Journal of Urology
2024;45(11):860-865
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the impact of benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) on the risk of cardiovascular diseases (CVD) recurrence.Methods:This study is a prospective cohort study based on the China Health and Retirement Longitudinal Study (CHARLS) database. The inclusion criteria were participants who underwent the national baseline survey in 2011. The exclusion criteria were as follows: ① female participants; ② participants without BPH/LUTS information at baseline; ③ participants who had not experienced CVD at baseline. The basic characteristics of BPH/LUTS patients and non-BPH/LUTS patients was compared. The Cox proportional hazards model was used to analyze whether BPH/LUTS is a risk factor for CVD recurrence.Results:A total of 903 male patients with stroke or heart disease were finally included, among which there were 324 (36.9%) cases of BPH/LUTS and 579 (64.1%) cases without BPH/LUTS. Patients with BPH/LUTS had a higher proportion of comorbidities such as hypertension [186 cases (57.4%) vs. 165 cases (28.5%), P=0.014], dyslipidemia [100 cases (31.2%) vs. 104 cases (18.2%), P<0.001], diabetes [55 cases (17.2%) vs. 57 cases (9.8%), P=0.002], chronic kidney disease [71 cases (22.2%) vs. 56 cases (9.8%), P<0.001], and chronic lung disease [87 cases (26.9%) vs. 117 cases (20.3%), P=0.029] compared to those without BPH/LUTS. During the 7-year follow-up, there were 341 (37.8%) cases of CVD recurrence, including 319 (35.3%) cases of heart disease recurrence and 38 (4.2%) cases of stroke recurrence. In the multifactorial adjusted Cox regression model, BPH/LUTS was a risk factor for CVD recurrence ( HR=1.41, 95% CI 1.12-1.77, P=0.003) and heart disease recurrence ( HR=1.40, 95% CI 1.10-1.77, P=0.005), while BPH/LUTS was not a risk factor for stroke recurrence ( HR=2.05, 95% CI 0.97-4.32, P=0.058). When stratified by age, in the population aged ≤65 years, BPH/LUTS was a risk factor for CVD ( HR=1.43, 95% CI 1.07-1.91, P=0.002) and heart disease recurrence ( HR=1.40, 95% CI 1.03-1.90, P=0.006), but not for stroke recurrence ( HR=2.16, 95% CI 0.98-6.09, P=0.053). In patients aged >65 years, BPH/LUTS was not a risk factor for CVD ( P=0.110), heart disease ( P=0.096), or stroke recurrence ( P=0.830). Conclusions:BPH/LUTS is closely related to an increased risk of CVD recurrence, especially for CVD patients aged ≤65 years old. Therefore, for elderly male CVD patients aged ≤65 years, preventing and actively treating BPH/LUTS may have significant implications.