Lazar Jason M, Posner Alexandra, Akbar Kamal, Tologonova Gulzhan, Monaghan Thomas, Murray Christopher, Weiss Jeffrey, Everaert Karel, DeBacker Tine, Helzner Elizabeth, Calixte Rose, Browne Rasheda, Goldman Sarah, Salciccioli Louis
Division of Cardiovascular Medicine, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC 1199, 11203-2098, Brooklyn, NY, USA.
Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
J Community Health. 2023 Apr;48(2):238-244. doi: 10.1007/s10900-022-01171-8. Epub 2022 Nov 12.
Although widely viewed as a urological condition, nocturia has been increasingly recognized to accompany various non-urological conditions such as hypertension and blood pressure (BP) elevation on office determination. Home BP monitoring (HBPM) has been shown superior to office-based readings and provides an opportunity to assess potential relationships between nocturia and novel indices derived from multiple BP recordings including BP load, BP variability, and arterial stiffness, which have prognostic significance. We retrospectively studied 103 home BP logs and nocturia frequencies provided by 61 stable cardiology patients ≥ 21 years without medication change. Nocturnal voids ranged from 0 to 5 voids per night, median: 1.5. Nocturia frequency was significantly correlated with home and office systolic BPs and with BP load, but not with diastolic BPs, BP variability or arterial stiffness. On Poisson regression analysis, the estimated prevalence ratio (PR) for home and office systolic BPs were 1.025 (CI: 1.01, 1.04; p < .001) and 1.01 (CI:1.00, 1.02; p = .019), indicating 2.5% and 1% increases in the risk of nocturia per mmHg increases in BP respectively. In conclusion, higher mean home and office systolic BPs are associated with self-reported nocturia frequency with stronger associations seen for home BP measurement. Nocturia frequency appears unrelated to mean home and office diastolic BPs. Nocturia may be related to BP load, (percentage of elevated BP values), but not to BP variability or arterial stiffness. Future prospective studies using HBPM are needed to confirm these findings and to contribute to the understanding of the elevated BP-nocturia link.
尽管夜尿症被广泛视为一种泌尿系统疾病,但人们越来越认识到它会伴随各种非泌尿系统疾病,如高血压以及在诊室测量时出现的血压升高。家庭血压监测(HBPM)已被证明优于诊室血压测量,并且提供了一个机会来评估夜尿症与从多次血压记录得出的新指标之间的潜在关系,这些指标包括血压负荷、血压变异性和动脉僵硬度,它们具有预后意义。我们回顾性研究了61名年龄≥21岁、病情稳定且未改变用药的心脏病患者提供的103份家庭血压记录和夜尿频率。夜间排尿次数为每晚0至5次,中位数为1.5次。夜尿频率与家庭和诊室收缩压以及血压负荷显著相关,但与舒张压、血压变异性或动脉僵硬度无关。在泊松回归分析中,家庭和诊室收缩压的估计患病率比(PR)分别为1.025(置信区间:1.01, 1.04;p <.001)和1.01(置信区间:1.00, 1.02;p =.019),表明血压每升高1 mmHg,夜尿症风险分别增加2.5%和1%。总之,较高的家庭和诊室平均收缩压与自我报告的夜尿频率相关,家庭血压测量的相关性更强。夜尿频率似乎与家庭和诊室平均舒张压无关。夜尿症可能与血压负荷(血压升高值的百分比)有关,但与血压变异性或动脉僵硬度无关。需要未来使用家庭血压监测的前瞻性研究来证实这些发现,并有助于理解血压升高与夜尿症之间的联系。