American journal of ophthalmology · 2025
Association Between Alpha-Blockers for Benign Prostatic Hyperplasia and Acute Angle-Closure Glaucoma.
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Baek Sung Uk, Kim Su Hwan, Ha Ahnul, Xi Chen, Kim Young Kook
Аннотация
OBJECTIVE: To investigate the association between alpha (α)-blockers use for benign prostatic hyperplasia (BPH) and the incidence of acute angle-closure glaucoma (AACG) in a nationwide population-based cohort.
DESIGN: Retrospective clinical cohort study.
PARTICIPANTS: This study analyzed data from the Korean National Health Insurance Sharing Service, encompassing nationwide health records from 2002 to 2022. A 1:5 propensity score-matched cohort was created using baseline covariates, ensuring balance between AACG cases and matched controls.
METHODS: Alpha-blocker use for BPH was identified by the presence of both a BPH diagnosis (KCD code N40) and a corresponding prescription prior to AACG diagnosis. Patients were categorized into three groups based on cumulative medication duration: Category 1 (≤23 days), Category 2 (24-202 days), and Category 3 (≥203 days).
MAIN OUTCOMES AND MEASURES: Incident AACG cases were identified using diagnostic and procedure codes, and hazard ratios (HR) were estimated using Cox proportional hazards models.
RESULTS: The final cohort included 30 450 participants, comprising 5075 AACG cases and 25 375 matched controls. Alpha-blocker use was associated with a significantly increased risk of AACG (adjusted HR, 1.52; 95% CI, 1.40-1.66; P < .001) compared to nonuse. A dose-response relationship was observed, with AACG incidence increasing from 0.15% among users with ≤23 days of exposure to 0.41% among those with ≥203 days.
CONCLUSIONS: This study demonstrates a significant, duration-dependent association between α-blocker use for BPH and an increased risk of AACG. These findings underscore the potential value of ophthalmologic evaluation when prescribing α-blockers, particularly for patients who may be anatomically predisposed to angle-closure events.
DESIGN: Retrospective clinical cohort study.
PARTICIPANTS: This study analyzed data from the Korean National Health Insurance Sharing Service, encompassing nationwide health records from 2002 to 2022. A 1:5 propensity score-matched cohort was created using baseline covariates, ensuring balance between AACG cases and matched controls.
METHODS: Alpha-blocker use for BPH was identified by the presence of both a BPH diagnosis (KCD code N40) and a corresponding prescription prior to AACG diagnosis. Patients were categorized into three groups based on cumulative medication duration: Category 1 (≤23 days), Category 2 (24-202 days), and Category 3 (≥203 days).
MAIN OUTCOMES AND MEASURES: Incident AACG cases were identified using diagnostic and procedure codes, and hazard ratios (HR) were estimated using Cox proportional hazards models.
RESULTS: The final cohort included 30 450 participants, comprising 5075 AACG cases and 25 375 matched controls. Alpha-blocker use was associated with a significantly increased risk of AACG (adjusted HR, 1.52; 95% CI, 1.40-1.66; P < .001) compared to nonuse. A dose-response relationship was observed, with AACG incidence increasing from 0.15% among users with ≤23 days of exposure to 0.41% among those with ≥203 days.
CONCLUSIONS: This study demonstrates a significant, duration-dependent association between α-blocker use for BPH and an increased risk of AACG. These findings underscore the potential value of ophthalmologic evaluation when prescribing α-blockers, particularly for patients who may be anatomically predisposed to angle-closure events.