Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, 410 North 12th Street, P.O. Box 980533, Richmond, VA 23298, USA.
J Gerontol A Biol Sci Med Sci. 2012 Dec;67(12):1373-8. doi: 10.1093/gerona/gls177. Epub 2012 Sep 12.
Medication use is a potentially reversible cause of urinary incontinence (UI). The objective of this longitudinal cohort study was to evaluate whether self-reported UI in community-dwelling older women is associated with the use of different classes of antihypertensive agents.
The sample consisted of 959 black and white women aged 72-81 years without baseline (Year 1) UI from the Health, Aging, and Body Composition Study. Use of any antihypertensive from 10 drug classes (ie, alpha blockers [central], alpha blockers [peripheral], angiotensin-converting enzyme inhibitors, angiotensin-II receptor blockers, beta blockers, calcium channel blockers, diuretics [loop], diuretics [potassium-sparing], diuretics [thiazide], and vasodilators) was determined during Year 3 in-person interviews. The number of unique antihypertensive agents used and the standardized daily dosage were also examined. Self-reported UI, operationally defined as leaking urine at least weekly during the previous 12 months, was assessed at Year 4 visits.
A total of 197 women (20.5%) reported UI at Year 4. Although any antihypertensive use, number of agents used, and standardized daily dosage at Year 3 were not associated with UI at Year 4, use of one particular drug class-peripheral alpha blockers (ie, doxazosin, prazosin, and terazosin)-was associated with fourfold greater odds of UI (adjusted odds ratio = 4.47; 95% confidence interval = 1.79-11.21; p = .0014). Further, in post hoc analyses, these odds nearly doubled in those also taking loop diuretics (adjusted odds ratio = 8.81; 95% confidence interval = 1.78-43.53; p = .0076).
In community-dwelling older women, peripheral alpha blocker use was associated with UI, and the odds nearly doubled when used with loop diuretics.
药物使用是导致尿失禁（UI）的一个潜在可逆转的原因。本纵向队列研究的目的是评估社区居住的老年女性自我报告的 UI 是否与使用不同类别的抗高血压药物有关。
该样本由 959 名年龄在 72-81 岁的黑人和白人女性组成，她们在基线时（第 1 年）没有 UI。在第 3 年的面对面访谈中，确定了使用来自 10 种药物类别的任何一种抗高血压药物（即，α受体阻滞剂[中枢]、α受体阻滞剂[外周]、血管紧张素转换酶抑制剂、血管紧张素-II 受体阻滞剂、β受体阻滞剂、钙通道阻滞剂、利尿剂[环]、保钾利尿剂、噻嗪类利尿剂和血管扩张剂）。还检查了使用的独特抗高血压药物数量和标准化日剂量。在第 4 年的就诊时评估了自我报告的 UI，操作定义为在过去 12 个月中至少每周漏尿。
共有 197 名女性（20.5%）在第 4 年报告 UI。尽管第 3 年的任何抗高血压药物使用、使用的药物数量和标准化日剂量与第 4 年的 UI 无关，但使用一种特定的药物类别-外周α受体阻滞剂（即多沙唑嗪、哌唑嗪和特拉唑嗪）与 UI 的四倍以上的可能性相关（调整后的优势比= 4.47；95%置信区间= 1.79-11.21；p=.0014）。此外，在事后分析中，这些可能性在同时服用环利尿剂的人群中几乎翻了一番（调整后的优势比= 8.81；95%置信区间= 1.78-43.53；p=.0076）。
在社区居住的老年女性中，外周α受体阻滞剂的使用与 UI 相关，当与环利尿剂一起使用时，可能性几乎增加一倍。
