Do lower urinary tract symptoms predict cardiovascular diseases in older men? A systematic review and meta-analysis

Abstract

PurposeTo study the incidence of CVD in men at risk, with and without LUTS. MethodsWe searched all longitudinal studies describing the association between LUTS and CVD (mortality) in October 2013 and December 2014 using MEDLINE, EMBASE, and the Cochrane Library Central Register. PRISMA criteria were met.ResultsWe included five studies with 6027 men with LUTS and 18,993 men without LUTS in the meta-analyses, with a follow-up period varying from 5 to 17 years. Studies totalled 2780 CVD events. No clear association between CVD and LUTS was demonstrated [pooled effect size: hazard ratio 1.09 (95 % CI 0.90–1.31); p = 0.40]. Two other studies reported the association between nocturia and (CVD) mortality. CVD-specific mortality risk was approximately two times higher for Japanese men with nocturia (357 men aged 70 years and over, 5-year follow-up). A univariable association between nocturia and all-cause mortality was found in Dutch men, but not in age-adjusted analyses (1114 men aged 50–78 years, 13-year follow-up). ConclusionThis meta-analysis conducted on longitudinal studies does not confirm LUTS to be a predictor of CVD in men without a history of CVD, despite the observed association between LUTS and CVD in cross-sectional studies.

Endothelial dysfunction, abnormal vascular structure and lower urinary tract symptoms in men and women

“…Gacci et al revealed that moderate to severe LUTS in men is strongly related to an increase in the risk of major cardiovascular events [7]. In contrast, Bouwman et al reported that LUTS in men is not a predictor of cardiovascular events [37]. In the present study, cardiovascular risk factors such as age, body mass index, glucose and Framingham risk score showed significant relationships with IPSS.…”

Relationship between lower urinary tract symptoms and cardiovascular risk scores including Framingham risk score and ACC/AHA risk score

“…Without these factors, even SRs with meta‐analyses could not show consistent conclusions. Although Gacci et al reported the significant association between those two disease entities, Bouwman et al reported no significant association between LUTS and CVD. Several studies suggested the possibility of BPH as an early manifestation of CVD risk rather than their direct cross‐sectional relationship between those two entities.…”

“…Rather, it is plausible to assume that CVD risks could aggravate the LUTS. There are several studies which support the latter direction by suggesting that c reactive protein, hyperlipidemia, and artheosclerosis could have a negative impact on LUTS . Moreover, there are few studies which show improvement of CVD risk by medication for LUTS, as well as medication for CVD improves LUTS.…”

Cluster analysis of multiple chronic conditions associated with urinary incontinence among women in the USA

“…Within three of the four clusters, the most prevalent chronic conditions, such as hypertension and hyperlipidaemia, are associated with increased CVD risk. There is increasing interest in the evaluation of how CVD may affect LUTS [31,32]. White matter hyperintensities in the CNS, which are associated with long-term CVD, are also associated with severity of UI in older adults [33].…”