Benign prostatic hyperplasia: the opposite effects of alcohol and coffee intake

Objective To assess several lifestyle factors influencing benign prostatic enlargement and therefore the severity of benign prostatic hyperplasia (BPH). Subjects and methods In age-stratified cohorts from population-based random samples of 882 men (aged 65, 70, 75 and 80 years) each participant completed a standardized questionnaire, including weight, height, socio-economic status, use of cigarettes, alcohol and coffee consumption. The questionnaire also elicited detailed information on the medical history of prostatic and (over the past month) lower urinary tract symptoms, applying all questions from the American Urology Association instrument. The lifestyle variables were evaluated for confounding by multiple logistic regression, controlling for age, relative weight and professional education, with those classified as having BPH analysed as the dependent variable. Results The prevalence of surgery for BPH increased with age from 15% at 65 years to 41% at 80 years. There was a strong inverse association between alcohol intake and men treated surgically for BPH or in 'watchful waiting' for surgical intervention, but a positive correlation with coffee consumption, and although not significantly, with the number of cigarettes smoked. Nevertheless, those who had never smoked have a slightly greater risk of BPH than current smokers. The body mass index and professional education were not associated with the risk of BPH. Conclusions Given the opposite effects of coffee and moderate alcohol consumption, together with the increased risk for clinical BPH in men with coronary heart disease, coffee constituents, which increase the serum concentration of low-density lipoprotein cholesterol, may be involved in the pathophysiology of BPH. Further epidemiological studies are needed to evaluate whether avoiding coffee intake reduces the risk of BPH.