title: Statin use and decreased risk of benign prostatic enlargement and lower urinary tract symptoms.
abstract: OBJECTIVE
  To determine whether statin use is associated with a decreased risk of developing benign prostatic enlargement (BPE) and lower urinary tract symptoms (LUTS).
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Epidemiology, Departments of Urology and Health Sciences Research and Cardiology, Mayo Clinic College of Medicine, Rochester, MN, USA. stsauver.jennifer@mayo.edu
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: St Sauver
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Jacobsen
authors.forename: Debra J
authors.initials: DJ
authors.lastname: Jacobson
authors.forename: Michaela E
authors.initials: ME
authors.lastname: McGree
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Girman
authors.forename: Ajay
authors.initials: A
authors.lastname: Nehra
authors.forename: Veronique L
authors.initials: VL
authors.lastname: Roger
authors.forename: Michael M
authors.initials: MM
authors.lastname: Lieber
mesh_terms: D000328:Adult; D000368:Aged; D004812:Epidemiologic Methods; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009929:Organ Size; D011467:Prostate / Q000473:pathology; D011470:Prostatic Hyperplasia / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D011472:Prostatitis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
references.citation: JAMA. 1993 Aug 18;270(7):860-4
references.pmid: 7688054
references.citation: J Urol. 2001 May;165(5):1521-5
references.pmid: 11342910
references.citation: Curr Pharm Des. 2009;15(5):467-78
references.pmid: 19199975
references.citation: Int J Epidemiol. 1994 Dec;23(6):1198-205
references.pmid: 7536718
references.citation: Mayo Clin Proc. 1996 Mar;71(3):266-74
references.pmid: 8594285
references.citation: Curr Urol Rep. 2008 Jul;9(4):272-8
references.pmid: 18765125
references.citation: Int J Obes (Lond). 2005 Mar;29(3):310-6
references.pmid: 15672112
references.citation: Am J Epidemiol. 2006 Jul 1;164(1):41-6
references.pmid: 16611664
references.citation: Eur Urol. 2007 Aug;52(2):503-9
references.pmid: 17343981
references.citation: Expert Opin Drug Saf. 2008 Nov;7(6):717-25
references.pmid: 18983218
references.citation: J Urol. 2005 Jun;173(6):1923-5
references.pmid: 15879782
references.citation: Am J Med. 2004 Aug 15;117(4):228-33
references.pmid: 15308431
references.citation: Ann Intern Med. 2002 Mar 5;136(5):341-8
references.pmid: 11874305
references.citation: Int Braz J Urol. 2008 Sep-Oct;34(5):555-61; discussion 561-2
references.pmid: 18986558
references.citation: J Clin Epidemiol. 2001 Sep;54(9):935-44
references.pmid: 11520654
references.citation: Urology. 1998 Mar;51(3):428-36
references.pmid: 9510348
references.citation: J Natl Cancer Inst. 2008 Nov 5;100(21):1511-8
references.pmid: 18957682
references.citation: J Clin Epidemiol. 2002 Jun;55(6):593-601
references.pmid: 12063101
references.citation: Lancet. 1991 Aug 24;338(8765):469-71
references.pmid: 1714529
references.citation: J Urol. 2010 Aug;184(2):494-9
references.pmid: 20620405
references.citation: Diabetes Care. 2008 Mar;31(3):476-82
references.pmid: 18071006
references.citation: Urology. 2006 Dec;68(6):1198-205
references.pmid: 17169643
references.citation: Eur Urol. 2007 Oct;52(4):964-72
references.pmid: 17618043
references.citation: J Urol. 1999 Apr;161(4):1174-9
references.pmid: 10081864
references.citation: Eur Urol. 1999 Apr;35(4):277-84
references.pmid: 10087388
references.citation: Urology. 1993 Dec;42(6):663-71
references.pmid: 7504848
references.citation: Am J Epidemiol. 2006 Oct 15;164(8):760-8
references.pmid: 16905643
references.citation: Mayo Clin Proc. 2000 Jul;75(7):681-7
references.pmid: 10907382
references.citation: BJU Int. 2007 Feb;99(2):347-54
references.pmid: 17313423
references.citation: J Urol. 1992 Nov;148(5):1549-57; discussion 1564
references.pmid: 1279218
references.citation: Urology. 2009 Mar;73(3):544-8
references.pmid: 19118873
references.citation: Trends Endocrinol Metab. 2008 May-Jun;19(4):113-21
references.pmid: 18356074
references.citation: Am J Epidemiol. 2003 May 15;157(10):906-14
references.pmid: 12746243
references.citation: BJU Int. 2008 Feb;101(3):313-8
references.pmid: 18005202
references.citation: J Urol. 2007 Apr;177(4):1395-400; quiz 1591
references.pmid: 17382740
references.citation: J Urol. 2005 Apr;173(4):1309-13
references.pmid: 15758787