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老年男性夜尿频繁与动脉僵硬度相关:滨名研究。

Frequent nocturnal urination in older men is associated with arterial stiffness: The Nagahama study.

机构信息

Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.

出版信息

Hypertens Res. 2019 Dec;42(12):1996-2001. doi: 10.1038/s41440-019-0309-4. Epub 2019 Aug 9.

Abstract

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.

摘要

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。

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