Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Hypertens Res. 2019 Dec;42(12):1996-2001. doi: 10.1038/s41440-019-0309-4. Epub 2019 Aug 9.
Nocturia in older adults has been reported to be a risk factor for cardiovascular outcomes, and the stiffening of large arteries might be an underlying mechanism. To clarify the possible association between nocturia and arterial stiffness, we analyzed a dataset from the Japanese general population. Study participants consisted of 5928 community residents (mean age: 60.0 ± 11.8 years). The frequency of nocturnal urination was recorded for 1 week using a sleep diary. Arterial stiffness was assessed by brachial-to-ankle pulse wave velocity (baPWV). Sleep blood pressure was measured automatically at 0000, 0200, and 0400 hours by wearing a cuff on the upper arm during sleep. The mean baPWV was 1278 ± 227 cm/s. The frequency of nocturnal urination showed a linear positive association with baPWV (P < 0.001). The association between a sleep diary-based nocturnal urination frequency > 1.5 times/night (corresponding to a ≥ 2 times/night frequency obtained by the questionnaire) and baPWV remained significant after adjusting for major covariates, including office blood pressure (β = 0.051, P < 0.001) and sleep blood pressure (β = 0.040, P < 0.001). This association was more prominent in men (β = 0.069, P < 0.001) than in women (β = 0.023, P = 0.013), particularly in older (β = 0.068, P = 0.006) compared with younger (β = 0.029, P = 0.270) men. Frequent nocturnal urination was independently associated with baPWV in older men. Nocturia may be a marker for cardiovascular disease risks that cannot be assessed by conventional risk factors such as blood pressure.
老年人夜尿症已被报道为心血管结局的危险因素,而大动脉僵硬可能是其潜在机制。为了阐明夜尿症与动脉僵硬之间可能存在的关联,我们分析了来自日本一般人群的数据。研究参与者包括 5928 名社区居民(平均年龄:60.0±11.8 岁)。使用睡眠日记记录了一周内夜间排尿的频率。通过在睡眠期间在上臂佩戴袖带,用肱踝脉搏波速度(baPWV)评估动脉僵硬。睡眠期间自动在 0000、0200 和 0400 小时测量睡眠血压。平均 baPWV 为 1278±227cm/s。夜间排尿频率与 baPWV 呈线性正相关(P<0.001)。在调整了主要混杂因素(包括诊室血压和睡眠血压)后,基于睡眠日记的夜间排尿频率>1.5 次/夜(对应于通过问卷获得的≥2 次/夜频率)与 baPWV 之间的关联仍然显著(β=0.051,P<0.001)。这种关联在男性中更为明显(β=0.069,P<0.001),而在女性中则不明显(β=0.023,P=0.013),尤其是在年龄较大的男性中更为明显(β=0.068,P=0.006)与年龄较小的男性(β=0.029,P=0.270)相比。频繁的夜间排尿与年龄较大的男性的 baPWV 独立相关。夜尿症可能是心血管疾病风险的标志物,这些风险不能通过血压等传统危险因素来评估。