The Effect of Chronic 5-Alpha Reductase Inhibition on Clinically Apparent and Silent Cardiovascular Events

This study investigated the impact of chronic finasteride use on cardiovascular events in 150 men with benign prostatic hyperplasia, comparing 50 treated with finasteride to 100 controls over an average follow-up of 60.3 months. The results showed no significant reduction in the prevalence of myocardial infarction, angioplasty, coronary artery bypass surgery, or peripheral vascular disease revascularization in the finasteride group compared to controls. However, there was a trend towards increased prevalence of new ECG abnormalities, such as q-waves or LBBB, in the finasteride group. The study concludes that while finasteride may lower cholesterol levels, it does not reduce the prevalence of clinically apparent cardiac events, indicating a dissociation between cholesterol lowering and cardiovascular event reduction.