α-Blocker and Risk of Dementia in Patients with Benign Prostatic Hyperplasia: A Nationwide Population Based Study Using the National Health Insurance Service Database

Bum Sik Tae, Byeong Jo Jeon, Hoon Choi, Jun Cheon, Jae Young Park, Jae Hyun Bae

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4 Citations (Scopus)

Abstract

PURPOSE: A recent study demonstrated that tamsulosin increased the risk of dementia in patients with benign prostatic hyperplasia. However, this study had a number of limitations. We evaluated the association between α-blockers and dementia in patients with benign prostatic hyperplasia. MATERIALS AND METHODS: From the National Health Insurance Service database we collected and analyzed data on α-blockers and dementia in the entire Korean adult population with benign prostatic hyperplasia between January 2011 and December 2011. These patients were followed until September 2017. We tested the effect of α-blockers on the risk of dementia using propensity score matched Cox proportional hazard regression models and Kaplan-Meier survival analysis. RESULTS: During a mean ± SD followup of 1,580 ± 674.3 days all study inclusion and exclusion criteria were met by 59,263 patients with benign prostatic hyperplasia. In the unadjusted cohort the incidence of dementia in the tamsulosin, doxazosin, terazosin, alfuzosin and no medication cohorts were 17.97%, 18.55%, 20.64%, 17.62% and 22.60%, respectively. After propensity score matching the risk of dementia did not significantly differ in the tamsulosin cohort vs the doxazosin and alfuzosin cohorts (HR 1.038, 95% CI 0.960-1.121 and HR 1.008, 95% CI 0.925-1.098), respectively. Compared to the tamsulosin cohort the terazosin cohort had a higher risk of dementia (HR 1.112, 95% CI 1.052-1.196). However, the risk of dementia was significantly lower in the terazosin cohort than in the no medication cohort. CONCLUSIONS: The study findings indicate that benign prostatic hyperplasia medication is not associated with a risk of dementia by duration of use or by type.

Original languageEnglish
Pages (from-to)362-368
Number of pages7
JournalThe Journal of urology
Volume202
Issue number2
DOIs
Publication statusPublished - 2019 Aug 1

Fingerprint

National Health Programs
Prostatic Hyperplasia
tamsulosin
Dementia
Terazosin
Databases
Population
Doxazosin
Propensity Score
Kaplan-Meier Estimate
Survival Analysis
Proportional Hazards Models
Incidence

Keywords

  • 5-alpha reductase inhibitors
  • dementia
  • prostate
  • prostatic hyperplasia
  • Republic of Korea

ASJC Scopus subject areas

  • Urology

Cite this

@article{5e27e86002dd4ecfaea880d25ef5e2cb,
title = "α-Blocker and Risk of Dementia in Patients with Benign Prostatic Hyperplasia: A Nationwide Population Based Study Using the National Health Insurance Service Database",
abstract = "PURPOSE: A recent study demonstrated that tamsulosin increased the risk of dementia in patients with benign prostatic hyperplasia. However, this study had a number of limitations. We evaluated the association between α-blockers and dementia in patients with benign prostatic hyperplasia. MATERIALS AND METHODS: From the National Health Insurance Service database we collected and analyzed data on α-blockers and dementia in the entire Korean adult population with benign prostatic hyperplasia between January 2011 and December 2011. These patients were followed until September 2017. We tested the effect of α-blockers on the risk of dementia using propensity score matched Cox proportional hazard regression models and Kaplan-Meier survival analysis. RESULTS: During a mean ± SD followup of 1,580 ± 674.3 days all study inclusion and exclusion criteria were met by 59,263 patients with benign prostatic hyperplasia. In the unadjusted cohort the incidence of dementia in the tamsulosin, doxazosin, terazosin, alfuzosin and no medication cohorts were 17.97{\%}, 18.55{\%}, 20.64{\%}, 17.62{\%} and 22.60{\%}, respectively. After propensity score matching the risk of dementia did not significantly differ in the tamsulosin cohort vs the doxazosin and alfuzosin cohorts (HR 1.038, 95{\%} CI 0.960-1.121 and HR 1.008, 95{\%} CI 0.925-1.098), respectively. Compared to the tamsulosin cohort the terazosin cohort had a higher risk of dementia (HR 1.112, 95{\%} CI 1.052-1.196). However, the risk of dementia was significantly lower in the terazosin cohort than in the no medication cohort. CONCLUSIONS: The study findings indicate that benign prostatic hyperplasia medication is not associated with a risk of dementia by duration of use or by type.",
keywords = "5-alpha reductase inhibitors, dementia, prostate, prostatic hyperplasia, Republic of Korea",
author = "Tae, {Bum Sik} and Jeon, {Byeong Jo} and Hoon Choi and Jun Cheon and Park, {Jae Young} and Bae, {Jae Hyun}",
year = "2019",
month = "8",
day = "1",
doi = "10.1097/JU.0000000000000209",
language = "English",
volume = "202",
pages = "362--368",
journal = "Journal of Urology",
issn = "0022-5347",
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T1 - α-Blocker and Risk of Dementia in Patients with Benign Prostatic Hyperplasia

T2 - A Nationwide Population Based Study Using the National Health Insurance Service Database

AU - Tae, Bum Sik

AU - Jeon, Byeong Jo

AU - Choi, Hoon

AU - Cheon, Jun

AU - Park, Jae Young

AU - Bae, Jae Hyun

PY - 2019/8/1

Y1 - 2019/8/1

N2 - PURPOSE: A recent study demonstrated that tamsulosin increased the risk of dementia in patients with benign prostatic hyperplasia. However, this study had a number of limitations. We evaluated the association between α-blockers and dementia in patients with benign prostatic hyperplasia. MATERIALS AND METHODS: From the National Health Insurance Service database we collected and analyzed data on α-blockers and dementia in the entire Korean adult population with benign prostatic hyperplasia between January 2011 and December 2011. These patients were followed until September 2017. We tested the effect of α-blockers on the risk of dementia using propensity score matched Cox proportional hazard regression models and Kaplan-Meier survival analysis. RESULTS: During a mean ± SD followup of 1,580 ± 674.3 days all study inclusion and exclusion criteria were met by 59,263 patients with benign prostatic hyperplasia. In the unadjusted cohort the incidence of dementia in the tamsulosin, doxazosin, terazosin, alfuzosin and no medication cohorts were 17.97%, 18.55%, 20.64%, 17.62% and 22.60%, respectively. After propensity score matching the risk of dementia did not significantly differ in the tamsulosin cohort vs the doxazosin and alfuzosin cohorts (HR 1.038, 95% CI 0.960-1.121 and HR 1.008, 95% CI 0.925-1.098), respectively. Compared to the tamsulosin cohort the terazosin cohort had a higher risk of dementia (HR 1.112, 95% CI 1.052-1.196). However, the risk of dementia was significantly lower in the terazosin cohort than in the no medication cohort. CONCLUSIONS: The study findings indicate that benign prostatic hyperplasia medication is not associated with a risk of dementia by duration of use or by type.

AB - PURPOSE: A recent study demonstrated that tamsulosin increased the risk of dementia in patients with benign prostatic hyperplasia. However, this study had a number of limitations. We evaluated the association between α-blockers and dementia in patients with benign prostatic hyperplasia. MATERIALS AND METHODS: From the National Health Insurance Service database we collected and analyzed data on α-blockers and dementia in the entire Korean adult population with benign prostatic hyperplasia between January 2011 and December 2011. These patients were followed until September 2017. We tested the effect of α-blockers on the risk of dementia using propensity score matched Cox proportional hazard regression models and Kaplan-Meier survival analysis. RESULTS: During a mean ± SD followup of 1,580 ± 674.3 days all study inclusion and exclusion criteria were met by 59,263 patients with benign prostatic hyperplasia. In the unadjusted cohort the incidence of dementia in the tamsulosin, doxazosin, terazosin, alfuzosin and no medication cohorts were 17.97%, 18.55%, 20.64%, 17.62% and 22.60%, respectively. After propensity score matching the risk of dementia did not significantly differ in the tamsulosin cohort vs the doxazosin and alfuzosin cohorts (HR 1.038, 95% CI 0.960-1.121 and HR 1.008, 95% CI 0.925-1.098), respectively. Compared to the tamsulosin cohort the terazosin cohort had a higher risk of dementia (HR 1.112, 95% CI 1.052-1.196). However, the risk of dementia was significantly lower in the terazosin cohort than in the no medication cohort. CONCLUSIONS: The study findings indicate that benign prostatic hyperplasia medication is not associated with a risk of dementia by duration of use or by type.

KW - 5-alpha reductase inhibitors

KW - dementia

KW - prostate

KW - prostatic hyperplasia

KW - Republic of Korea

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