Presented Tuesday, 04 September 2007 at the 29th Congress of the Societe International d'Urologie - SIU 2007 - Optimizing Clinical Outcomes in Prostate and Renal Cell Carcinomas - The Second Annual Symposium on Advanced GU Malignancy - Palais des Congres de Paris, France

Introduction: Antimuscarinics are the main drugs used to treat patients with (OAB). They have proven efficacy and are generally considered to be safe. However, interest has refocused on potential cardiovascular problems. Several long-term follow- up studies have suggested that an elevated heart rate (HR) increases the risk of cardiovascular disease, sudden death in patients with cardiovascular disorders and all-cause mortality. Since both OAB and cardiovascular disease increase with age, many OAB patients will have simultaneous cardiovascular disorders. Depending on their muscarinic receptor profile, antimuscarinics have the potential to increase heart rate which may be important when treating OAB patients. In the present study, the distribution of HRs prior to the initiation of treatment with antimuscarinics, and the prevalence of cardiovascular comorbidities in OAB patients were explored, utilizing large databases.

Methods: From the United Healthcare (UHC) data base, 78,291 OAB patients ≥18 years with pre-existing cardiovascular conditions were identified from medical claims that were related to ventricular arrhythmias, other conduction disorders, hypertension, ischemic heart diseases, heart failure, and cerebrovascular disease. Additional data from the GE healthcare database were obtained on OAB patients that were treated with antimuscarinics. HRs from the day the drugs were prescribed were recorded and categorized.

Results: In the UHC database, 78,291 OAB patients, treated with antimuscarinics, were identified, on average 57 years old. The total prevalence of cardiovascular diseases was 47%. Over 1/3 of the 78,291 patients had hypertension. In the GE database 16,833 OAB patients were identified; 13.0% were male and 56.9% were ≥65 years. The mean HR was 76 beats per minute (bpm), and 38.8% of patients had HRs exceeding 80 bpm. Females were more likely than males to have a HR ≥80 bpm and those <65 years of age were more likely than those ≥65 years to have a HR ≥80 bpm.

Conclusion: A high proportion of OAB patients have cardiovascular diseases. In the studied OAB patient population, 35% had HRs ≥80 bpm prior to initiating OAB drug treatment. Depending on their muscarinic receptor profile, antimuscarinics have a potential to increase HR, and baseline HR should be considered when prescribing these drugs to OAB patients.

Authors: Andersson KE, Kahler K, Ebinger U

UroToday.com Full Conference Coverage

Please log-in or register in order to submit comments.

Powered by AkoComment!