MedicalResearch.com Interview with:
Blayne Welk MD
Assistant Professor in the Division of Urology
Department of Surgery, Western University Institute for Clinical Evaluative Sciences
Department of Epidemiology and Biostatistics
Western University, London, Ontario
Medical Research: What is the background for this study? What are the main findings?
Dr. Welk: Alpha blocker medications are used to treat urinary symptoms in men. They are very commonly prescribed, especially among the elderly. One of the potential side effects of these medications is low blood pressure and fainting. Newer medications are designed to be more specific to the prostate, in order to try and reduce these risks. Previous studies have had conflicting results regard the risk of low blood pressure, and whether this risk translates into clinically relevant complications like serious falls, fractures or head injury.
This study demonstrated that there is a small, but significant increase in the risk of falls, fractures and head injury associated with the initiation of prostate specific alpha blockers. Most men, however have a very low risk of these events to begin with, so the absolute change in their risk is very small. The mechanism of these outcomes is likely mediated through hypotension, which was also diagnosed in the majority of men with a fall or fracture.
Medical Research: What should clinicians and patients take away from your report?
Dr. Welk: Men starting alpha blocker medication for urinary symptoms should be counselled about the potential risk of low blood pressure and fainting. While not dangerous most of the time, these medications can lead to fractures and head injuries, which have serious consequences in the elderly. Avoiding dangerous activities when first starting these medications, and taking the mediation at night time may help avoid these risks.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Welk: Further research could examine the the role of 5 alpha reductase inhibitors (also used for male urinary symptoms) in modulating the risk of falls and fractures in men being treated with alpha blockers.
Welk Blayne, McArthur Eric, Fraser Lisa-Ann,Hayward Jade, Dixon Stephanie, Hwang Y Joseph et al. The risk of fall and fracture with the initiation of a prostate-selective α antagonist: a population based cohort study 2015; 351 :h5398
Blayne Welk MD (2015). Men Have Small Risk of Falls and Fractures When Starting Prostate Alpha Blockers