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
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:①female 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％CI0.98-6.09,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.
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