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Study of heart rate variability in benign prostatic hyperplasia - A hospital-based study

Ruchika Agarwal, Ruchi Tyagi, Naveen Gaur, Shashank Mishra, Saurabh Kansal.

Abstract
Background: Benign prostatic hyperplasia (BPH) is a major disease affecting middle-aged and elderly male. BPH is the result of unregulated proliferation of connective tissue, smooth muscle, and glandular epithelium within the prostatic zone resulting in lower urinary tract symptoms. The exact etiopathogenesis of BPH remains ambiguous, but there is increasing evidence that sympathetic overactivity appears to have an important role in the pathogenesis of BPH. Undoubtedly, the constellations of cellular, pathologic processes that give rise to symptoms of BPH are far complex than we currently realize. Only by unraveling these complexities, we will be able to successfully design alternative strategies to treat and prevent the adverse impact of BPH.

Aims and Objectives: This study aims to evaluate the role of autonomic nervous system in the pathogenesis of BPH.

Materials and Methods: After taking clearance from the ethical committee, a total of 42 male patients who were diagnosed clinically and ultrasonologically as cases of BPH were included in the study after applying appropriate inclusion and exclusion criteria. Patients were scored for the International Prostate Symptom Score (IPSS). The basal recording of electrocardiogram in lead II was done for 5 min. The Polyrite D was used for heart rate variability by frequency domain method. Pearsonís correlation coefficient was calculated for low frequency (LF) versus IPSS and LF versus prostate size.

Results: LF component was found significantly high in BPH patients. R value for LF versus IPSS was 0.9558 showing an increase in a sympathetic component with increase in IPSS which is statistically significant (P < 0.001). Patients with higher LF value had more lower urinary tract symptoms. R value for LF versus prostate size was 0.9421 which is also statistically significant (P < 0.001). This means if there is increase in the prostate size sympathetic activity also increased.

Conclusion: This study was done with an aim to recommend methods of primordial prevention and our study shows greater sympathetic activity in BPH patients. Hence, we suggest yogic interventions such as meditation for primordial prevention.

Key words: Heart Rate Variability; Benign Prostatic Hyperplasia; International Prostate Symptom Score


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