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Keywords:

  • Statins;
  • BPH;
  • prostate

Study Type – Prevention (individual cohort) Level of Evidence 2b

What’s known on the subject? and What does the study add?

Statin medications reduce inflammation. Inflammation may be important in causing prostate enlargement and lower urinary tract symptoms in aging men. Therefore, statin use may decrease inflammation and help prevent prostate enlargement and lower urinary tract symptoms.

Men who took statin medications were less likely to develop an enlarged prostate or lower urinary tract symptoms compared to men who did not take statins. Additionally, men who took statins for the longest period of time had the lowest risk of developing these urological problems. These results suggest that statin use may help prevent common urological problems in aging men.

OBJECTIVE

  • • 
    To determine whether statin use is associated with a decreased risk of developing benign prostatic enlargement (BPE) and lower urinary tract symptoms (LUTS).

SUBJECTS AND METHODS

  • • 
    We conducted a retrospective, population-based cohort study of 2447 men, 40–79 years of age, residing in Olmsted County, MN, USA, in 1990, and followed these men biennially through 2007.
  • • 
    Cox proportional hazard models were used to assess associations between statin use and new onset of moderate/severe LUTS (American Urological Association Symptom Index score >7), a decreased maximum urinary flow rate (<12 mL/s) or BPE (prostate volume >30 mL).

RESULTS

  • • 
    Statin use was inversely associated with new onset of LUTS (Hazard ratio (HR) 0.39; 95% confidence interval (CI) 0.31–0.49), a decreased maximum flow rate (HR 0.53; 95% CI 0.34–0.82) and BPE (HR 0.40; 95% CI 0.23–0.69) after adjustment for baseline age and body mass index, diabetes, hypertension, coronary heart disease, smoking, alcohol use, activity level and non-steroidal anti-inflammatory use.
  • • 
    The longest duration of statin use was associated with the lowest risk of developing each outcome (all tests for trend: P < 0.001).

CONCLUSION

  • • 
    In this study, statin use was associated with a 6.5- to 7-year delay in the new onset of moderate/severe LUTS or BPE.
  • • 
    While men typically take statin medications to prevent coronary heart disease events and related outcomes, these data suggest that men who use statins may also receive urologic benefits.