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J Prev Med Public Health > Volume 42(3); 2009 > Article
Journal of Preventive Medicine and Public Health 2009;42(3): 165-170. doi: http://dx.doi.org/10.3961/jpmph.2009.42.3.165
The Risk of Fracture with Taking Alpha Blockers for Treating Benign Prostatic Hyperplasia.
Joongyub Lee, Nam Kyoung Choi, Sun Young Jung, Ye Jee Kim, Jong Mi Seong, Seung June Oh, Byung Joo Park
1Department of Preventive Medicine, Seoul National University College of Medicine, Korea. bjpark@snu.ac.kr
2Department of Urology, Seoul National University College of Medicine, Korea.
3Medical Research Center, Seoul National University, Korea.
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.
Key words: Benign prostatic hyperplasia; Adrenergic alpha antagonist; Adverse drug reactions; Fracture; Case-crossover study
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