Cardiovascular Risk Factors and Ethnicity Are Independent Factors Associated with Lower Urinary Tract Symptoms

Abstract

ObjectivesTo determine the lower urinary tract symptoms (LUTS) profile and factors affecting its degree of severity including cardiovascular risk profile, age, ethnicity, education level and prostate volume in a multiethnic Asian setting.Materials and MethodsWe conducted a cross-sectional study of 1021 men aged 40–79 years with no clinical evidence of prostate cancer, prostate surgery or 5α-reductase inhibitor treatment of known prostate conditions. The severity of LUTS was assessed using the International Prostate Symptom Score (IPSS). Potential factors associated with LUTS including age, ethnicity, education, history of hypertension, diabetes and hypercholesterolemia, height, weight, and prostate volume were evaluated using univariable and multivariable analyses.ResultsThere were 506 (50%) men found to have moderate-to-severe LUTS attaining an IPSS above 7. Overall, nocturia (45.5%) was the most frequently reported symptom. Multivariable analysis showed that age, ethnicity, prostate volume and history of hypertension and hypercholesterolemia were independent factors associated with severity of LUTS (p < 0.05). Considering individual lower urinary tract symptoms, we found a strong association of storage symptom with history of hypertension and hypercholesterolemia. Malay men were significantly bothered by post micturition symptom compared to their Chinese and Indian counterparts. Stratified analyses of LUTS demonstrated a mutually exclusive cardiovascular risk factors profile defined by ethnicity.ConclusionSeverity of LUTS varies between different ethnicities across all age groups. In addition to age and prostate volume, ethnicity and cardiovascular risk factors including hypertension and hypercholesterolemia may also need to be taken into account in managing men with LUTS.

Prevalence and risk factors of lower urinary tract symptoms in Chinese adult men: a multicentre cross-sectional study

“…Similar to other studies, our data showed an increase in the prevalence of moderate to severe LUTS with advancing age. The prevalence of LUTS in our study was much lower compared with other studies based in Europe [ 3 – 5 , 7 , 14 ], the US [ 6 ], South America [ 18 ], Hong Kong [ 12 ] and other Asian countries [ 3 , 10 ], especially among people aged over 50 years. Nevertheless, a similar prevalence was found between this study and another 2 population-based studies in Norway [ 8 ] and Singapore [ 9 ], for men who were younger than 50 and 70 years, respectively.…”

“…Nevertheless, a similar prevalence was found between this study and another 2 population-based studies in Norway [ 8 ] and Singapore [ 9 ], for men who were younger than 50 and 70 years, respectively. This difference in the prevalence may be partially due to the different study designs (face-to-face interviews or self-completed questionnaires), population characteristics such as their jobs or areas, and people's ethnicity and life habits [ 3 , 10 ]…”

“…LUTS is a cluster of chronic urinary symptoms in the bladder, prostate or urethra, and a major cause of benign prostatic hyperplasia (BPH) [ 2 ]. Population-based studies on the prevalence of LUTS have been conducted in the United States, Europe and Asia, in countries such as Korea, Singapore and Malaysia [ 3 – 10 ]. However, there has been no population-based study of LUTS in mainland China, except for two investigations conducted in Hong Kong.…”

Daily salt intake is an independent risk factor for pollakiuria and nocturia

“…In fact, as mentioned in the Introduction section, various types of diseases and chronic illness are known to cause increased urinary frequency. Interestingly, these pollakiuria‐related pathological conditions are thought to have an association with excessive salt intake . Therefore, we focused on daily salt intake in the present study.…”

“…Reportedly, increased urinary frequency causes various pathophysiological conditions and lifestyle diseases, such as cardiovascular disease, diabetes mellitus, renal dysfunction, lower urinary obstruction and primary sleep disorders . Most previous reports suggest that hypertension strongly influences LUTS, including pollakiuria, and one of the chief causative factors of hypertension is excessive salt intake . Furthermore, salt intake is known to be a direct and/or indirect cause of pollakiuria‐related diseases, such as hypertension, cardiovascular disease and diabetic nephropathy .…”