Association of life’s crucial 9 score with benign prostatic hyperplasia: a cross-sectional study

BACKGROUND: Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are prevalent prostate diseases in aging male populations, with significant implications for quality of life and healthcare burden. While cardiovascular health (CVH) and lifestyle factors have been linked to aging and chronic diseases, their association with prostate diseases remains underexplored. OBJECTIVE: This study investigates the relationship between CVH, assessed using the Life's Crucial 9 (LC9) score, and the risk of prostate diseases, including BPH and PCa, in a large UK cohort. METHODS: Data from 26,656 male participants in the UK Biobank were analyzed. The LC9 score, an expanded CVH metric incorporating mental health, was calculated based on physical, metabolic, and psychological factors. Logistic regression and restricted cubic spline analyses were performed to examine associations between the LC9 score and prostate diseases. Subgroup and interaction analyses were conducted to explore potential modifiers. RESULTS: A higher LC9 score was significantly associated with a lower risk of BPH in both continuous and categorical models (P < 0.001). The association demonstrated a linear dose-response relationship, with the inflection point at an LC9 score of 72.5. Subgroup analysis revealed stronger protective effects in participants with lower socioeconomic deprivation. However, no significant association was observed between the LC9 score and PCa risk, even in subgroup analyses. CONCLUSIONS: This study highlights the importance of overall cardiovascular and psychological health in reducing BPH risk, emphasizing the need for sustained healthy behaviors. The absence of a significant link between the LC9 score and PCa suggests distinct pathophysiological mechanisms and warrants further research. These findings provide valuable insights for targeted prevention and management strategies in prostate health.