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Urinary incontinence and cardiovascular disease: a narrative review

Abstract

Introduction and hypothesis

Urinary incontinence (UI) has recently been associated with increased mortality. This observation deserves consideration, since UI is a frequent condition. Shared risk with cardiovascular disease and UI could offer part of the explanation.

Methods

In this narrative review, we explore the association between UI and some cardiovascular risk factors: obesity, diabetes, high blood pressure, tobacco smoking, alcohol, and caffeine intake. We also review the benefit of cardiovascular risk management on bladder health.

Results

Bladder function is affected by many cardiovascular risk factors. They can be protective or detrimental. Obesity, diabetes, and, to a lesser extent, high blood pressure and cigarette smoking have been associated with UI in different settings, precede new onset UI in longitudinal studies, have a dose effect, and have a biologic mechanism linked with UI. Thus, UI could be considered a possible consequence of metabolic syndrome. Furthermore, prevention programs aimed at decreasing weight, quitting smoking, healthy diet, and increasing physical activity have resulted in a decreased incidence, prevalence, and severity of UI.

Conclusions

Knowing the association among UI, cardiovascular risk factors, and mortality should encourage UI screening in the population as well as cardiovascular risk factor screening among patients with UI. The secondary benefit for UI could be an important motivator for increasing adherence to cardiovascular prevention programs.

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Acknowledgements

I gratefully acknowledge Simone Madigan for her correction of the English manuscript.

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Correspondence to Gregor John.

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John, G. Urinary incontinence and cardiovascular disease: a narrative review. Int Urogynecol J 31, 857–863 (2020). https://doi.org/10.1007/s00192-019-04058-w

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Keywords

  • Cardiovascular risk factor
  • Mortality
  • Urinary incontinence