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Risk factors for clinical benign prostatic hyperplasia in a community-based population of healthy aging men.

Abstract

We defined risk factors for a clinical diagnosis of benign prostatic hyperplasia (BPH) among subjects of the population-based Massachusetts Male Aging Study. In 1987-89 1709 men aged 40-70 provided baseline risk factor data and were followed for a mean of 9 years; 1019 men without prostate cancer provided follow-up data. We classified men with clinical BPH at follow-up if they reported (1) frequent or difficulty urinating and were told by a health professional that they had an enlarged or swollen prostate or (2) if they reported having surgery for BPH. At follow-up the prevalence of clinical BPH was 19.4%, increasing from 8.4% of men aged 38-49 years to 33.5% of men aged 60-70 years (P < 0.001 for trend). Elevated free PSA levels (age- and total PSA-adjusted OR, top vs. bottom quartile ng/mL 4.4, 95% CI 1.9-10.5), heart disease (age-adjusted OR 2.1, CI 1.3-3.3), and use of beta-blocker medications (OR 1.8, CI 1.1-3.0) increased odds for BPH, while current cigarette smoking (OR 0.5, CI 0.3-0.8) and high levels of physical activity (top vs. bottom quartile kcals/day OR 0.5, CI 0.3-0.9) decreased odds of BPH. All but the medication effects persisted in fully adjusted multivariable models. Total or fat calorie intake, sexual activity level, alcohol intake, body mass index, waist-hip ratio, diastolic blood pressure, a history of diabetes, hypertension, vasectomy, or serum levels of androgens or estrogens did not individually predict clinical BPH. We conclude that physical exercise and cigarette smoking appear to protect against development of clinical BPH. Elevated free PSA levels predict clinical BPH independent of total PSA levels. Risk associated with heart disease does not appear to be due solely to detection bias or to effects of heart disease medications. A wide variety of other characteristics appear to have no influence on risk for clinical BPH.

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  • Authors+Show Affiliations

    ,

    General Medicine Unit, Medical Services, Massachusetts General Hospital and Harvard Medical School, 50 Staniford Street, Boston, MA 02114, USA. jmeigs@partners.org

    , , ,

    Source

    Journal of clinical epidemiology 54:9 2001 Sep pg 935-44

    MeSH

    Adult
    Age Factors
    Aged
    Aging
    Data Collection
    Humans
    Male
    Massachusetts
    Middle Aged
    Prostate-Specific Antigen
    Prostatic Hyperplasia
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    11520654

    Citation

    Meigs, J B., et al. "Risk Factors for Clinical Benign Prostatic Hyperplasia in a Community-based Population of Healthy Aging Men." Journal of Clinical Epidemiology, vol. 54, no. 9, 2001, pp. 935-44.
    Meigs JB, Mohr B, Barry MJ, et al. Risk factors for clinical benign prostatic hyperplasia in a community-based population of healthy aging men. J Clin Epidemiol. 2001;54(9):935-44.
    Meigs, J. B., Mohr, B., Barry, M. J., Collins, M. M., & McKinlay, J. B. (2001). Risk factors for clinical benign prostatic hyperplasia in a community-based population of healthy aging men. Journal of Clinical Epidemiology, 54(9), pp. 935-44.
    Meigs JB, et al. Risk Factors for Clinical Benign Prostatic Hyperplasia in a Community-based Population of Healthy Aging Men. J Clin Epidemiol. 2001;54(9):935-44. PubMed PMID: 11520654.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Risk factors for clinical benign prostatic hyperplasia in a community-based population of healthy aging men. AU - Meigs,J B, AU - Mohr,B, AU - Barry,M J, AU - Collins,M M, AU - McKinlay,J B, PY - 2001/8/25/pubmed PY - 2001/9/21/medline PY - 2001/8/25/entrez SP - 935 EP - 44 JF - Journal of clinical epidemiology JO - J Clin Epidemiol VL - 54 IS - 9 N2 - We defined risk factors for a clinical diagnosis of benign prostatic hyperplasia (BPH) among subjects of the population-based Massachusetts Male Aging Study. In 1987-89 1709 men aged 40-70 provided baseline risk factor data and were followed for a mean of 9 years; 1019 men without prostate cancer provided follow-up data. We classified men with clinical BPH at follow-up if they reported (1) frequent or difficulty urinating and were told by a health professional that they had an enlarged or swollen prostate or (2) if they reported having surgery for BPH. At follow-up the prevalence of clinical BPH was 19.4%, increasing from 8.4% of men aged 38-49 years to 33.5% of men aged 60-70 years (P < 0.001 for trend). Elevated free PSA levels (age- and total PSA-adjusted OR, top vs. bottom quartile ng/mL 4.4, 95% CI 1.9-10.5), heart disease (age-adjusted OR 2.1, CI 1.3-3.3), and use of beta-blocker medications (OR 1.8, CI 1.1-3.0) increased odds for BPH, while current cigarette smoking (OR 0.5, CI 0.3-0.8) and high levels of physical activity (top vs. bottom quartile kcals/day OR 0.5, CI 0.3-0.9) decreased odds of BPH. All but the medication effects persisted in fully adjusted multivariable models. Total or fat calorie intake, sexual activity level, alcohol intake, body mass index, waist-hip ratio, diastolic blood pressure, a history of diabetes, hypertension, vasectomy, or serum levels of androgens or estrogens did not individually predict clinical BPH. We conclude that physical exercise and cigarette smoking appear to protect against development of clinical BPH. Elevated free PSA levels predict clinical BPH independent of total PSA levels. Risk associated with heart disease does not appear to be due solely to detection bias or to effects of heart disease medications. A wide variety of other characteristics appear to have no influence on risk for clinical BPH. SN - 0895-4356 UR - https://www.unboundmedicine.com/medline/citation/11520654/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0895-4356(01)00351-1 DB - PRIME DP - Unbound Medicine ER -