Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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The Risk of Fracture with Taking Alpha Blockers for Treating Benign Prostatic Hyperplasia

양성전립선비대증 증상 조절을 위해 투여되는 알파차단제의 골절위헙

  • Lee, Joong-Yub (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Choi, Nam-Kyoung (Department of Preventive Medicine, Seoul National University College of Medicine, Medical Research Center, Seoul National University) ;
  • Jung, Sun-Young (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Kim, Ye-Jee (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Seong, Jong-Mi (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Oh, Seung-June (Department of Urology, Seoul National University College of Medicine) ;
  • Park, Byung-Joo (Department of Preventive Medicine, Seoul National University College of Medicine)
  • 이중엽 (서울대학교 의과대학 예방의학교실) ;
  • 최남경 (서울대학교 의과대학 예방의학교실) ;
  • 정선영 (서울대학교 의과대학 예방의학교실) ;
  • 김예지 (서울대학교 의과대학 예방의학교실) ;
  • 성종미 (서울대학교 의과대학 예방의학교실) ;
  • 오승준 (서울대학교 의과대학 비뇨기과학교실) ;
  • 박병주 (서울대학교 의과대학 예방의학교실)
  • Published : 2009.05.31
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Abstract

Objectives : We evaluated the risk of fracture associated with hypotension-related adverse drug reaction caused by taking alpha blockers to treat benign prostatic hyperplasia (BPH). Methods : We used the Health Insurance Review and Assessment Service database from January 1st 2005 to June 30th 2006 for this study. The male patients with BPH and who had a prescription for alpha blockers following any fractures were defined as the cases. We set the 20 day long hazard period prior to the index date and the four control periods whose lengths were same with hazard period. After 1:4 matching of the hazard and control periods, conditional logistic regression was used to calculate the odds ratios for the risk of fractures as related to the alpha blocker exposure. Results : Doxazosin and tamsulosin showed the increased risk of fractures, whereas terazosin did not. After stratification using the defined daily doses, a protective effect was shown for the patients who took terazosin at the doses lower than 0.4 DDD and the hazardous effect at the doses higher than or equal to 0.4 DDD. There was no significant difference for the risk of patients taking tamsulosin at the doses higher than 1.0 DDD but there was a statistically significant increase in the risk at the doses higher than or equal to 1.0 DDD. Conclusions : Alpha blockers for BPH may increase the risk of fracture in elderly patients who have comorbidities and take the concomitant medications. Alpha blockers need to be prescribed with caution, although some have high prostate specificity.

Keywords

References

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