Relationship between benign prostatic hyperplasia and history of coronary artery disease in elderly men

Study Objective. To assess the relationship between the occurrence of benig n prostatic hyperplasia (BPH), an androgen-dependent disease, and coronary artery disease (defined as history of coronary artery bypass grafting, coro nary angioplasty, myocardial infarction) in elderly men. Design. Retrospective chart review. Setting. Urology practice. Patients. Seven hundred two elderly men aged 65- 80 years. Intervention. The men's charts were reviewed for data pertaining to coronar y artery disease, risk factors for coronary artery disease, and serum prost ate-specific antigen (PSA) levels. Men who had medical conditions, pharmaco logic interventions, or surgical procedures that could alter PSA, and those taking lipid-lowering agents were not included. Measurements and Main Results. PSA levels correlate positively with prostat ic volume of BPH. In men with levels under 1.0 mu g/L (no BPH) and over 1.0 mu g/L (BPH present), the frequency of coronary artery disease was 9% and 29%, respectively (p<0.03). No significant differences were noted between g roups in other accepted risk factors for coronary artery disease including age, smoking, diabetes mellitus, or hypertension. Conclusion. Smooth muscle proliferation is an important and possibly androg en-dependent step in the development of atherosclerosis and BPH. Prospectiv e studies are required to assess the effect of antiandrogens on atheroscler osis.