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Are lower urinary tract symptoms associated with cardiovascular disease in the Dutch general population? Results from the Krimpen study

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Abstract

Purpose

To describe the association between lower urinary tract symptoms (LUTS) and cardiovascular diseases (CVD), with adjustment for age and other confounders. We were specifically interested in the possible predictive value of LUTS to the incidence of CVD in the future in the general population.

Methods

We performed post hoc analyses using data from the Krimpen study, a large community-based study in the Netherlands. All men aged 50–75 years, without prostate or bladder cancer, a history of radical prostatectomy, or neurogenic bladder disease, were invited to participate for a response rate of 50 %. At baseline, 1,610 men were included. CVD status was compared to LUTS category, using logistic regression, providing odds ratios with 95 % confidence intervals (OR 95 % CI). For the longitudinal analyses in men without CVD at baseline, hazard ratios (HR) and 95 % CI were estimated using Cox proportional hazard models with the occurrence of a CVD as outcome variable.

Results

At baseline, 362 men (22 %) had a history of CVD. The ORs for CVD for men with moderate to severe LUTS were 2.04 (unadjusted, 95 % CI 1.58–2.63), 1.86 (1.43–2.41, adjusted for age), and 1.81 (1.38–2.37, adjusted for age and other confounders). Of the 1,248 CVD-free men, 58 (4.6 %) had a CVD event. HRs for moderate to severe LUTS were 0.98 (95 % CI 0.52–1.86, unadjusted) and 1.08 (0.57–2.07, adjusted for age, obesity, hypertension, and erectile dysfunction).

Conclusions

The cross-sectional analyses revealed a clear correlation between moderate to severe LUTS and CVD. In longitudinal analyses, however, no significant association was shown.

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References

  1. Zakaria L, Aristotelis GA, Shabsigh R (2001) Common conditions of the aging male: erectile dysfunction, benign prostatic hyperplasia, cardiovascular disease and depression. Int Urol Nephrol 33:283–292

    Article  CAS  PubMed  Google Scholar 

  2. Rosen RC (2005) Reproductive health problems in ageing men. Lancet 366:183–184

    Article  PubMed  Google Scholar 

  3. Yach D, Hawkes C, Gould CL, Hofman KJ (2004) The global burden of chronic diseases: overcoming impediments to prevention and control. JAMA 291(21):2616–2622

    Article  CAS  PubMed  Google Scholar 

  4. Ponholzer A, Temml C, Wehrberger C, Marszalek M, Madersbacher S (2006) The association between vascular risk factors and lower urinary tract symptoms in both sexes. Eur Urol 50:581–586

    Article  PubMed  Google Scholar 

  5. Ng CF, Wong A, Li ML, Chan SY, Mak SK, Wong WS (2007) The prevalence of cardiovascular risk factors in male patients who have lower urinary tract symptoms. Hong Kong Med J 13:421–426

    CAS  PubMed  Google Scholar 

  6. Sandfeldt L, Hahn RG (2003) Cardiovascular risk factors correlate with prostate size in men with bladder outlet obstruction. BJU Int 92:64–68

    Article  CAS  PubMed  Google Scholar 

  7. Michel MC, Heeman U, Schumacher H, Mehlburger L, Goepel M (2004) Association of hypertension with symptoms of benign prostatic hyperplasia. J Urol 172:1390–1393

    Article  PubMed  Google Scholar 

  8. Karatas OF, Bayrak O, Cimentepe E, Unal D (2010) An insidious risk factor for cardiovascular disease: benign prostatic hyperplasia. Int J Cardiol 144(3):452

    Article  PubMed  Google Scholar 

  9. Fitzgerald MP, Link CL, Litman HJ, Travison TG, McKinlay JB (2007) Beyond the lower urinary tract: the association of urologic and sexual symptoms with common illnesses. Eur Urol 52:407–415

    Article  PubMed Central  PubMed  Google Scholar 

  10. Bouwman II, Kollen BJ, van der Meer K, Nijman RJ, van der Heide WK (2014) Are lower urinary tract symptoms in men associated with cardiovascular diseases in a primary care population: a registry study. BMC Fam Pract 15:9

    Article  PubMed Central  PubMed  Google Scholar 

  11. Lin H-J, Weng S-F, Yang C-M, Wu M-P (2013) Risk of hospitalization for acute cardiovascular events among subjects with lower urinary tract symptoms: a nationwide population-based study. PloS One 8:e66661

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Wehrberger C, Temml C, Gutjahr G, Berger I, Rauchenwald M, Ponholzer A, Madersbacher S (2011) Is there an association between lower urinary tract symptoms and cardiovascular risk in men? A cross sectional and longitudinal analysis. Urology 78(5):1063–1067

    Article  PubMed  Google Scholar 

  13. Lightner DJ, Krambeck AE, Jacobson DJ, McGree ME, Jacobsen SJ, Lieber MM, Roger VL, Girman CJ, St Stauver JL (2012) Nocturia is associated with an increased risk of coronary heart disease and death. BJU Int 110(6):848–853

    Article  PubMed Central  PubMed  Google Scholar 

  14. Blanker MH, Prins J, Bosch JL, Schouten BW, Bernsen RM, Groeneveld FP, Bohnen AM (2005) Loss to follow-up in a longitudinal study on urogenital tract symptoms in Dutch older men. Urol Int 75(1):30–37

    Article  PubMed  Google Scholar 

  15. Blanker MH, Groeneveld FP, Prins A, Bernsen RM, Bohnen AM, Bosch JL (2000) Strong effects of definition and nonresponse bias on prevalence rates of clinical benign prostatic hyperplasia: the Krimpen study of male urogenital tract problems and general health status. BJU Int 85(6):665–671

    Article  CAS  PubMed  Google Scholar 

  16. Barry MJ, Fowler FJ Jr, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, Cockett AT (1992) The American urological association symptom index for benign prostatic hyperplasia. J Urol 148:1549–1557

    CAS  PubMed  Google Scholar 

  17. Donovan JL, Abrams P, Peters TJ, Kay HE, Reynard J, Chapple C, De la Rosette JJ, Kondo A et al (1996) The ICS-“BPH” Study: the psychometric validity and reliability of the ICS male questionnaire. Br J Urol 77:554–562

    Article  CAS  PubMed  Google Scholar 

  18. Lamberts H, Wood M (1987) ICPC: International classification of primary care. Oxford University Press, Oxford

    Google Scholar 

  19. Schouten BW, Bohnen AM, Bosch JL, Bernsen RM, Deckers JW, Dohle GR, Thomas S (2008) Erectile dysfunction prospectively associated with cardiovascular disease in the Dutch general population: results from the Krimpen study. Int J Impot Res 20(1):92–99

    Article  CAS  PubMed  Google Scholar 

  20. Antitrombotic Trialists Collaboration (2002) Collaborative meta-analysis of randomized trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 324:71–86

    Article  Google Scholar 

  21. Frankel SJ, Donovan JL, Peters TI, Abrams P, Dabhoiwala NF, Osawa D, Lin AT (1998) Sexual dysfunction in men with lower urinary tract symptoms. J Clin Epidemiol 51:677–685

    Article  CAS  PubMed  Google Scholar 

  22. Nagelkerke NJD (1991) A note on a general definition of the coefficient of determination. Biometrika 78(3):691–692

    Article  Google Scholar 

  23. Kim S, Jeong JY, Choi YJ, Kim DH, Lee WK, Lee SH, Lee SK (2010) Association between lower urinary tract symptoms and vascular risk factors in aging men: the hallym aging study. Korean J Urol 51:477–482

    Article  PubMed Central  PubMed  Google Scholar 

  24. Rohrmann S, Smit E, Giovannucci E, Platz EA (2005) Association between markers of the metabolic syndrome and lower urinary tract symptoms in the 3rd National Health and Nutrition Examination Survey (NHANES III). Int J Obes 29:310–316

    Article  CAS  Google Scholar 

  25. Feinstein M, Ning H, Kang J, Bertoni A, Carnethon M, Lloyd-Jones DM (2012) Racial differences in risks for first cardiovascular events and noncardiovascular death: the atherosclerosis risk in communities study, the cardiovascular health study, and the multi-ethnic study of atherosclerosis. Circulation 126:50–59

    Article  PubMed Central  PubMed  Google Scholar 

  26. Kupelian V, Fitzgerald MP, Kaplan SA, Norgaard JP, Chiu GR, Rosen RC (2011) Association of nocturia and mortality: results from the Third National Health and Nutrition Examination Survey. J Urol 185(2):571–577

    Article  PubMed  Google Scholar 

  27. van Doorn B, Kok ET, Blanker MH, Westers P, Bosch JL (2012) Mortality in older men with nocturia. A 15-year follow up of the Krimpen study. J Urol 187(5):1727–1731

    Article  PubMed  Google Scholar 

  28. Muller-Nordhorn J, Binting S, Roll S, Willich SN (2008) An update on regional variation in cardiovascular mortality within Europe. Eur Heart J 29:1316–1326

    Article  PubMed  Google Scholar 

  29. Wiersma T, Smulders YM, Stehouwer CD, Konings KT, Lanphen J (2012) Summary of the multidisciplinary guideline on cardiovascular risk management (revision 2011). Ned Tijdschr Geneeskd 156(36):A5104

    PubMed  Google Scholar 

  30. Hall SA, Chiu GR, Link CL, Steers WD, Kupelian V, McKinlay JB (2011) Are statin medications associated with lower urinary tract symptoms in men and women? Results from the Boston Area Community Health (BACH) Survey. Ann Epidemiol 21:149–155

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

We thank Prof. Dr. K. Van der Meer for his comments on an earlier version of the manuscript.

Conflict of interest

The authors declare that they have no competing interests.

Ethical standard

The Medical Ethics Committee of the Erasmus Medical Center Rotterdam, the Netherlands, approved the study. All persons gave their informed consent prior to their inclusion in the study.

Author information

Authors and Affiliations

  1. Department of General Practice, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands

    Inge I. Bouwman, Marco H. Blanker & Wouter K. van der Heide

  2. Department of General Practice, Erasmus Medical Center, Burg. S’Jacobsplein 51, 3015 CA, Rotterdam, The Netherlands

    Boris W. V. Schouten & Arthur M. Bohnen

  3. Department of Urology, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands

    Rien J. M. Nijman

  4. Department of Urology, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands

    J. L. H. Ruud Bosch

Authors
  1. Inge I. Bouwman
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  2. Marco H. Blanker
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  3. Boris W. V. Schouten
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  4. Arthur M. Bohnen
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  5. Rien J. M. Nijman
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  6. Wouter K. van der Heide
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  7. J. L. H. Ruud Bosch
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Correspondence to Inge I. Bouwman.

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Bouwman, I.I., Blanker, M.H., Schouten, B.W.V. et al. Are lower urinary tract symptoms associated with cardiovascular disease in the Dutch general population? Results from the Krimpen study. World J Urol 33, 669–676 (2015). https://doi.org/10.1007/s00345-014-1398-y

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  • DOI: https://doi.org/10.1007/s00345-014-1398-y

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