Nocturia is Associated with High Atherosclerotic Cardiovascular Disease Risk in Women: Results from the National Health and Nutrition Examination Survey

Abstract

Growing evidence has identified nocturia as a potential manifestation of several cardiovascular disease states. We aimed to determine whether a relationship exists between nocturia and global atherosclerotic cardiovascular disease (ASCVD) risk, defined by the American College of Cardiology/American Heart Association (ACC/AHA) ASCVD risk calculator, using a large nationally-representative study sample from the United States. We explored potential associations between nocturia and ASCVD risk in adults aged 40–79 years with no prior history of overt/known atherosclerotic disease from 7 consecutive cycles of the National Health and Nutrition Examination Survey. Subjects were classified by whether they met the ASCVD high-risk threshold following current ACC/AHA consensus guidelines (10-year major adverse cardiovascular event risk ≥ 20%). Logistic regression analyses were used to explore associations between nocturia (defined as ≥ 2 nocturnal voids) and ASCVD risk. The prevalence of nocturia and high ASCVD risk were 27.0% and 10.9%, respectively. Nocturia, older age, increased body mass index, and diuretic use were associated with high ASCVD risk on univariate logistic regression. After adjusting for age, body mass index, and diuretic use, nocturia remained associated with significantly greater odds of high ASCVD risk in females but not in males. Elicitation of nocturia on clinical history taking may serve to identify high cardiovascular risk in females. Future studies are needed to elucidate mechanisms underlying this association.

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Authors

Contributions

Conceptualization: JML, MDC, TFM; Methodology: JML, MDC, TFM; Formal Analysis and Investigation: JML, MDC, TFM; Writing—Original Draft Preparation: JML, TFM; Writing—Review and Editing: JML, MDC, JPW, KE, TDB, AJW, FCB, TFM; Funding Acquisition: N/A; Resources: N/A; Supervision: AJW, FCB.

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Correspondence to Jason M. Lazar.

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Conflict of interest

Jason M. Lazar has no direct or indirect commercial incentive associated with publishing this article and certifies that all conflicts of interest relevant to the subject matter discussed in the manuscript are the following: Dr. Weiss is a consultant for Ferring and the Institute for Bladder and Prostate Research, outside the submitted work. Dr. Everaert is a consultant and lecturer for Medtronic and Ferring and reports institutional grants from Allergan, Ferring, Astellas, and Medtronic, outside the submitted work. Dr. Wein has served as an advisor/consultant for Bulkamid, Medtronic, Serenity, Urovant, and Velicept, outside the submitted work. The additional authors have nothing to disclose.

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Lazar, J.M., Chobufo, M.D., Weiss, J.P. et al. Nocturia is Associated with High Atherosclerotic Cardiovascular Disease Risk in Women: Results from the National Health and Nutrition Examination Survey. J Community Health (2021). https://doi.org/10.1007/s10900-021-00962-9

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Keywords

  • Atherosclerosis
  • Cardiovascular
  • LUTS
  • Marker
  • Nocturia