Is there an association between lower urinary tract symptoms and cardiovascular risk in men? A cross sectional and longitudinal analysis.

OBJECTIVE

To investigate the association between lower urinary tract symptoms (LUTS) and both coronary vascular disease (CVD) and stroke in men in a cross-sectional and longitudinal setting.

MATERIAL AND METHODS

Men aged 30-92 years underwent a free health investigation and completed the International Prostate Symptom Score questionnaire. In the cross-sectional part, the 10-year CVD and stroke risks were estimated according to the Framingham risk score. In the follow-up period (mean 6.1 years) the CVD and stroke events were recorded.

RESULTS

Two-thousand ninety-two men aged 47.8 years (SD 11.5) were analyzed. No to mild LUTS were present in 1,738 men, 337 men had moderate LUTS, and 17 had severe LUTS. The 10-year risk (cross-sectional design) for CVD or stroke in men with no to mild, moderate, and severe LUTS was 8.8%, 10.6%, and 15.9% (P <.01) and 6.9%, 7.5%, and 11.7% (P <.01), respectively. Adjusted for age, diabetes, total and low-density lipoprotein cholesterol, the odds ratios for CVD and stroke risk were 0.98 (P = .58) and 0.99 (P = .72) for moderate and 1.28 (P = .03) and 1.66 (P <.01) for severe LUTS. During follow-up, 96 events (CVD or stroke) were recorded: Men with no to mild, moderate, and severe LUTS had 76 (4.4%), 15 (4.5%), and 5 (29.4%) events, respectively. The adjusted (see above) hazard ratios were 0.63 (P = .16) for moderate and 3.82 (P = .01) for severe LUTS.

CONCLUSION

Although moderate LUTS do not seem to be a risk factor for CVD and stroke, men with severe LUTS were at increased risk for both according to a cross-sectional and longitudinal analysis. Studies with a larger group of men with severe LUTS are warranted to further substantiate these observations.