1
|
Chen J, Liu Z, Yang L, Zhou J, Ma K, Peng Z, Dong Q. Relationship between nocturia and hypertension: findings from the NHANES 2005-2016. Front Cardiovasc Med 2023; 10:1165092. [PMID: 37485277 PMCID: PMC10357039 DOI: 10.3389/fcvm.2023.1165092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/14/2023] [Indexed: 07/25/2023] Open
Abstract
Objectives The objective of this study was to explore the association between nocturia and hypertension in a large, nationally representative adult sample. Methods We used data from 2005 to 2016 National Health and Nutritional Examination Surveys (NHANES). A total of 29,505 participants aged 20 years old or older were included. A participant was considered to have nocturia if he or she had two or more voiding episodes at night. Multivariable logistic regression models were used to explore the association between nocturia and hypertension. Results Participants with nocturia were associated with a higher risk of hypertension (OR, 1.36; 95% CI, 1.28-1.45). Interaction tests revealed no significant effect of sex, age, race, or body mass index on the association of nocturia with hypertension. As the severity of nocturia increases, the risk of hypertension increases (P for trend <0.0001). In addition, nocturia was also related to different grades of hypertension (II vs. I: OR, 1.34, 95% CI, 1.16-1.55; III vs. I: OR, 1.67, 95% CI, 1.32-2.13). Conclusion In this cross-sectional study, our results suggest that nocturia is associated with an increased risk for hypertension.
Collapse
Affiliation(s)
- Junhao Chen
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Zhenghuan Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Luchen Yang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Jing Zhou
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Kai Ma
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Zhufeng Peng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Dong
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
2
|
Chan G, Qu LG, Gani J. Urodynamic findings in patients with nocturia and their associations with patient characteristics. Can Urol Assoc J 2022; 16:E455-E460. [PMID: 35426788 PMCID: PMC9484743 DOI: 10.5489/cuaj.7792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
INTRODUCTION This study identified associations between lower urinary tract pathology confirmed on urodynamic testing, baseline characteristics, and symptoms for adults with nocturia. Nocturia frequency was examined for predictors. METHODS This retrospective study from 2012-2019 analyzed adult patients with nocturia (waking to void ≥2x/night) referred for urodynamic testing (UDS). Data on baseline characteristics, symptoms, UDS parameters, and lower urinary tract pathology were recorded. Males and females were analyzed separately, and univariable analyses were conducted, stratified by lower urinary tract pathology. Multivariable regression models were fit. Nocturia frequency was analyzed for associations with clinical parameters. RESULTS Altogether, 372 patients were included (159 men and 213 women). More men had detrusor overactivity (DO) (p<0.001) and bladder outlet obstruction (BOO) (p<0.001). DO was associated with storage symptoms (odds ratio [OR] 5.19, p<0.001), in addition to older age (p=0.009) and being male (p<0.001). Detrusor under-activity (DU) was associated with voiding symptoms (OR 1.92, p=0.004), older age (p<0.001), and being female (p=0.018). BOO was associated voiding symptoms (OR 2.09, p=0.023), younger age (p=0.018), and being male (p<0.001). The quantity of lower urinary tract symptoms was associated with DU and DO. Nocturia frequency was not associated with baseline variables or underlying pathologies. A substantial number of patients were diagnosed with DU alone (n=69, 18.7%) or associated with other diagnoses (n=108, 29.3%). CONCLUSIONS Careful assessment of risk factors and symptoms may help identify underlying lower urinary tract pathology for adults with nocturia. DU is found in a significant proportion of patients with nocturia, a previously under-reported result.
Collapse
Affiliation(s)
- Garson Chan
- Division of Urology, Department of Surgery, University of Saskatchewan, Saskatoon, SK, Canada
| | - Liang G. Qu
- Department of Urology, University of Melbourne, Austin Health, Heidelberg, Victoria, Australia
- Young Urology Researchers Organisation (YURO), Australia
| | - Johan Gani
- Department of Urology, University of Melbourne, Austin Health, Heidelberg, Victoria, Australia
- Department of Urology, University of Melbourne, Western Health, Footscray, Victoria, Australia
| |
Collapse
|
3
|
Miller CD, Monaghan TF, Robins DJ, Weiss JP. Does traditional pharmacotherapy augment behavioral modification in the treatment of nocturia? Neurourol Urodyn 2021; 40:1133-1139. [PMID: 33973671 DOI: 10.1002/nau.24692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/31/2021] [Accepted: 04/15/2021] [Indexed: 11/07/2022]
Abstract
AIMS To assess the efficacy of traditional first-line non-antidiuretic pharmacotherapy for nocturia in the real-world outpatient urology setting. METHODS We retrospectively analyzed voiding diaries from adult men treated for lower urinary tract symptoms (LUTS) at an outpatient urology clinic to identify pairs of voiding diaries with ≥1 nocturnal void at baseline and a corresponding follow-up diary completed within 1 year. We compared the odds of nocturia improvement (decrease of ≥1 nocturnal void) in patients started on LUTS pharmacotherapy versus behavioral modification alone. RESULTS Two hundred and thirteen diary pairs from 93 patients were included. Fifty-seven diary pairs were identified from patients prescribed at least one LUTS drug on the initial visit and 156 diary pairs were identified from patients receiving behavioral modification alone. All standard voiding diary parameters were assessed, and only maximum voided volume differed at baseline (240 ml [interquartile range: 200-330 ml] vs. 280 ml [200-400 ml] with and without pharmacotherapy, respectively, p = 0.04). The odds of nocturia improvement did not significantly differ between pharmacotherapy and behavioral modification treatment groups (crude odds ratio [OR]: 1.16 [95% confidence interval: 0.63-2.16], p = 0.63; maximum voided volume [MVV]-adjusted OR: 1.19 [0.63-2.22], p = 0.59). In contrast, improvement in 24-h urinary frequency was more likely with pharmacotherapy versus behavioral modification alone (crude OR: 2.36 [1.22-4.56], p = 0.01; MVV-adjusted OR: 2.05 [1.05-4.01], p = 0.04). Results were consistent on subgroup analyses restricted to first diary pairs from each patient. CONCLUSION Despite improvement in 24-h voiding frequency, there was no evidence that adjunctive pharmacotherapy provided a benefit in the treatment of nocturia in men receiving behavioral counseling.
Collapse
Affiliation(s)
- Connelly D Miller
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.,Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Thomas F Monaghan
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.,Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Dennis J Robins
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.,Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Jeffrey P Weiss
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.,Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
| |
Collapse
|
4
|
Monaghan TF, Khargi R, Miller CD, Agudelo CW, Bruha MJ, Fink LE, Lazar JM, Everaert K, Weiss JP. The modified nocturia index: Refining the workup for nocturia. Neurourol Urodyn 2020; 40:555-557. [PMID: 33053219 DOI: 10.1002/nau.24545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/20/2020] [Accepted: 10/06/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Thomas F Monaghan
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Raymond Khargi
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Connelly D Miller
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Christina W Agudelo
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Matthew J Bruha
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Lauren E Fink
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Jason M Lazar
- Department of Medicine, Division of Cardiovascular Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Jeffrey P Weiss
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| |
Collapse
|
5
|
Nocturnal Urine Production in Women With Global Polyuria. Int Neurourol J 2020; 24:270-277. [PMID: 33017897 PMCID: PMC7538286 DOI: 10.5213/inj.2040166.083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/18/2020] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Low nocturnal urine production (NUP) may be sufficient to rule out global polyuria (GP) in men. This study determines the sensitivity of indices for nocturnal polyuria (NP), defined as nocturnal polyuria index (NPi; nocturnal urine volume/24-hour urine volume) ≥0.33 or NUP ≥90 mL/hr, for detecting GP in women. METHODS Data were analyzed from 2 prospective protocols involving subjects recruited from a urology ambulatory care unit and a continence clinic. Women ≥18 years with nocturia were included if they met either of 2 common criteria for GP: (1) ≥40 mL/kg/24 hr or (2) ≥3,000 mL/24 hr. RESULTS Thirty-one women were included (NPi, 28.6 [21.3-40.7]; NUP, 100.8 [68.3-135.8] mL/hr). At the ≥40 mL/kg/24-hr cutoff, 40% and 63% of women reporting ≥1 nocturnal void(s) (n=30) had NPi ≥0.33 and NUP ≥90 mL/hr, respectively. Additionally, 53% and 71% of subjects reporting ≥2 nocturnal voids (n=17) had NPi ≥0.33 and NUP ≥90 mL/hr, respectively. At the ≥3,000 mL/24-hr cutoff, 38% and 69% of women reporting ≥1 nocturnal void(s) (n=13) had NPi ≥0.33 and NUP ≥90 mL/hr, respectively, and 63% and 88% of subjects reporting ≥2 nocturnal voids (n=8) had NPi ≥0.33 and NUP ≥90 mL/hr, respectively. By extension, 37%-62% of women with nocturia and GP did not have NP by NPi ≥0.33 criteria, and 12%-37% did not have NP by NUP ≥90 mL/hr criteria. CONCLUSION Indices of excess nighttime urination do not reliably predict GP in women. A full-length voiding diary may be particularly important in the evaluation of women with nocturia. Nocturia in women merits further consideration as a distinct entity.
Collapse
|