Falling once you pass age 30 or so is a big deal. Falling is one of the leading causes of trauma in the elderly.
Nonselective α-antagonists (e.g., doxazosin, terazosin), which were introduced initially as antihypertensive drugs, often cause dizziness and hypotension when they are used to treat men with urinary symptoms of benign prostatic hyperplasia (BPH). Several decades ago, prostate-selective α-antagonists with fewer hypotensive effects (i.e., tamsulosin, alfuzosin, and silodosin) were introduced specifically for treating patients with BPH. In this population-based cohort study, researchers used an Ontario administrative database to identify 147,000 men (age, ≥66) who filled first outpatient prescriptions for a prostate-selective α-antagonist to determine whether starting treatment with one of these drugs is associated with excess risks for falls and fractures. Using propensity-score matching, researchers also identified a cohort of similar men who did not fill prostate-specific α-antagonist prescriptions.
At 90 days, men exposed to prostate-selective α-antagonists had significantly higher risks for hospitalization or emergency department visits for falling (odds ratio, 1.14), fractures (OR, 1.16), hypotension (OR, 1.80), or head trauma (OR, 1.15) than did nonexposed men. Absolute additional risk for each of these outcomes was about 1 or 2 events per 1000 users of selective α-antagonists.
The original article can be found here.