drugs can cause heart failure


  • Taking alpha-blockers, indicated for the treatment of benign prostatic hyperplasia, can increase the risk of heart failure by up to 22%.
  • If the statistical probability is significant, the absolute risk of developing heart failure is low in the absence of other risk factors.
  • You should therefore not interrupt your treatment and discuss it with your doctor.

Common in men from 50 years old, benign prostatic hyperplasia (BPH) occurs when the prostate becomes too large and interferes with urine output. It is then usually treated with two types of drugs: 5-alpha-reductase inhibitors which decrease the size of the prostate and alpha-blockers (AB) which relax the smooth muscles.

However, the latter would be involved in the increased risk of heart failure, estimates a new study published in the Journal of Urology. According to its authors, the risk would be higher in men taking AB rather than 5-alpha reductase inhibitors (5-ARI). “Although no one should stop taking their BPH medications based on these results, our study provides new evidence to understand the complex interplay of factors affecting the risk of heart disease in men with BPH. “, explains Dr Siemens of Queen’s University in Ontario (Canada).

A 22% increase in risk

To better understand the link between BPH medications and heart failure, researchers used health data from Ontario to identify more than 175,000 men with benign prostatic hypertrophy. About 55,000 patients were treated with AB alone, 8,000 with 5-ARI alone, and 41,000 with a combination of AB and 5-ARI. The rest were not taking either of the two types of BPH medications.

After analyzing the follow-up data, the researchers found that the risk of developing heart failure was 22% higher in men taking AB alone, 16% higher in those taking combination therapy, and 9% higher in those taking 5-ARIs alone, compared to the control group of men not taking BPH drugs.

The risk of heart failure was especially higher with the intake of old alpha-blockers called “non-selective” compared to the new “selective” ABs. It was also higher in men taking AB for an extended period: 14 months or more.

A real but low risk

However, researchers want to be reassuring to men taking this type of medication: the increased likelihood of developing heart failure is statistically high, but the absolute risk remains relatively low. In addition, risk factors such as previous heart disease, high blood pressure, and diabetes have a much greater impact on the risk of heart failure than BPH medications.

Men with benign prostatic hyperplasia should therefore continue to take their medication, although it is important that doctors “including primary care physicians and urologists”, be aware of this risk and inform “patients who have already suffered from heart disease or who have cardiovascular risk factors”.


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