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夜尿症与女性动脉粥样硬化性心血管疾病风险升高相关:来自全国健康和营养调查的结果。

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

机构信息

Division of Cardiovascular Medicine, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, 11203, USA.

Department of Medicine, Interfaith Medical Center, Brooklyn, NY, USA.

出版信息

J Community Health. 2021 Aug;46(4):854-860. doi: 10.1007/s10900-021-00962-9. Epub 2021 Jan 25.

DOI:10.1007/s10900-021-00962-9
PMID:33495885
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.

摘要

越来越多的证据表明,夜尿症是几种心血管疾病的潜在表现。我们旨在使用来自美国的一项大型全国代表性研究样本,确定夜尿症与美国心脏病学会/美国心脏协会 (ACC/AHA) 动脉粥样硬化性心血管疾病 (ASCVD) 风险计算器定义的全球动脉粥样硬化性心血管疾病 (ASCVD) 风险之间是否存在关系。我们探讨了在无明显/已知动脉粥样硬化病史的 40-79 岁成年人中,夜尿症与 ASCVD 风险之间的潜在关联,这些成年人来自美国国家健康和营养检查调查的连续 7 个周期。根据当前 ACC/AHA 共识指南(10 年主要不良心血管事件风险 ≥ 20%),根据他们是否符合 ASCVD 高危阈值对受试者进行分类。逻辑回归分析用于探讨夜尿症(定义为 ≥ 2 次夜间排尿)与 ASCVD 风险之间的关联。夜尿症和高 ASCVD 风险的患病率分别为 27.0%和 10.9%。单变量逻辑回归显示,夜尿症、年龄较大、体重指数增加和利尿剂使用与 ASCVD 风险较高相关。在校正年龄、体重指数和利尿剂使用后,夜尿症与女性 ASCVD 高风险的关联仍然显著,但与男性无关。在临床病史采集时询问夜尿症可能有助于识别女性的高心血管风险。需要进一步的研究来阐明这种关联的机制。

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2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.2019 ACC/AHA 心血管疾病一级预防指南:执行摘要:美国心脏病学会/美国心脏协会临床实践指南工作组的报告。
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