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Nocturnal Polyuria and Hypertension in Patients with Lifestyle Related Diseases and Overactive Bladder
Yokoyama O. et al.
The Journal of Urology, Volume 197, Issue 2, February 2017, Pages 423–431
Commentary by Philip Van Kerrebroeck
These Japanese urologists aim at an investigation of the relationship of nocturnal polyuria in patients with common lifestyle related diseases and overactive bladder, with special attention to hypertension. They performed a multicentre cross-sectional study in which, after baseline assessment, patients recorded 24-hour urinary frequency/volume, blood pressure and heart rate for 3 days. Based on mean blood pressure the patients were stratified into 4 groups, including no hypertension, and controllable, untreated and uncontrolled hypertension, respectively. They collected data on 2,353 patients, who had urinary urgency once or more per week and 1 or more nocturnal toilet visits. Patients were enrolled from 543 sites in Japan, and complete data, including the 24-hour frequency volume chart, were collected from 1,271. Multivariable analyses showed a statistically significant association of nocturnal polyuria with increasing age (OR 1.04, 95% CI 1.02-1.05, p <0.001) and gender (women vs. men OR 0.75, 95% CI 0.59-0.96, p = 0.02), and for controllable (OR 1.10, 95% CI 0.83-1.460), untreated (OR 2.62, 95% CI 1.55-4.45) and uncontrolled (OR 1.15, 95% CI 0.81-1.62) hypertension vs. no hypertension (p = 0.005). After a separate assessment in men and women, it appeared that hypertension and heart rate were significantly associated with nocturnal polyuria in women alone (p = 0.01 and 0.03, respectively).Obviously lower urinary tract symptoms suggestive of benign prostatic hyperplasia were significantly associated with nocturnal polyuria in men alone (p <0.001).
This study that collected data in a large group of clearly defined patients that nocturnal polyuria is significantly associated with age, male gender, and untreated hypertension in patients with lifestyle related diseases and overactive bladder. However it seems that the association between hypertension and nocturnal polyuria is only significant in women.