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Calcium Antagonists Use and Its Association with Lower Urinary Tract Symptoms: A Cross-Sectional Study.

ABSTRACT: Lower urinary tract symptoms (LUTS) have been reported amongst the side effects of calcium antagonists (CA). CAs act on the bladder by affecting the ability of the detrusor muscle to create enough contractile force to overcome obstruction to normal voiding. We aimed to determine the relationship between CA use and LUTS in general medical inpatients.In this cross-sectional study we recruited 278 medical inpatients (including 85 CA users) aged ≥40 (72.1±13.7) years. LUTS was assessed using the International Prostate Symptoms Score (IPSS) questionnaire. A Logistic regression model using a 'backwards-elimination' strategy was used to identify variables associated with LUTS and for calculating the adjusted odds ratios and the 95% confidence intervals (CI). After adjusting for other risk factors and drugs, patients on amlodipine/nifedipine and diltiazem/verapamil (compared to non-users) were more likely to suffer from severe LUTS [Males: 12.45(CI: 1.57-98.63) and Females: 7.75(CI: 0.94-63.94)] and moderate-to-severe LUTS [Males: 17.43(CI: 2·26-134.39) and Females: 47.8(CI: 6.22-367.37)]. Patients on felodipine/lercanidipine were less likely to suffer from either severe or moderate-to-severe LUTS. Further, 19 (22.4%) CA-users were on treatment for LUTS compared to 18 (9.3%) of the non-users group, p = 0.003. Both male and female CA-users were three times more likely to be on alpha-blockers than non-users, p<0.001. CA-users were more likely to have undergone urinary tract-related surgery (Males: two times, p = 0.07 and females: nine times, p = 0.029). The study was limited by the fact that a causal relationship could not be established between CA use and LUTS.Our results demonstrate an association between CA use and an increasing severity of LUTS. They also demonstrate that CA-users are more likely to have medical or surgical treatment for LUTS. However, these CA's effects on LUTS vary, and the use of highly vascular selective agents does not appear to pose significant risk.

SUBMITTER: Elhebir ES

PROVIDER: S-EPMC3689686 | biostudies-other | 2013

REPOSITORIES: biostudies-other

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Project description:Lower urinary tract symptoms (LUTS) are reported to affect over half of all adults, and they are associated with significantly impaired quality of life (QOL). We performed a population-based study to evaluate the overall prevalence and impact of LUTS including overactive bladder (OAB) in adults aged ?40 years in China.Adults aged ?40 years were eligible to participate in this internet-based survey, provided that they had the ability to access the internet, to use a computer and to read the local language. The survey contained questions relating to International Continence Society (ICS) symptom definitions, the International Prostate Symptom Score (IPSS) and the Overactive Bladder Symptom Score (OABSS). The primary study objective was to determine the prevalence of LUTS using the ICS 2002 symptom definition.Among the 4136 respondents, 2080 (50.3%) were men and 1347 (32.6%) were aged ?60 years. LUTS prevalence according to ICS criteria was 60.3% in men and 57.7% in women. All 3 ICS symptom groups (voiding, storage, and postmicturition) were present in 22.8% of women and 24.2% of men, making this the most common combination of ICS symptom groups. The most bothersome symptoms were terminal dribble and nocturia. According to IPSS scores, 32.9% of participants had at least moderate symptoms. The prevalence of OAB was 23.9%. The presence of LUTS-particularly all 3 ICS symptom groups-was associated with reduced sexual QOL in women, reduced satisfaction with erectile function in men, higher anxiety and depression scores, and reduced health-related QOL (physical health and mental health domains). The overall percentage of participants with LUTS visiting healthcare professionals for urinary symptoms was 38%.In conclusion, LUTS affect the majority of adults aged ?40 years in China, and prevalence increases with increasing age. LUTS are associated with impaired QOL and mental health, but fewer than half of individuals in China with LUTS seek healthcare for their symptoms. There is therefore a need to improve awareness and treatment of the condition.ClinicalTrials.gov identifier: NCT02618421.

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Calcium Antagonists Use and Its Association with Lower Urinary Tract Symptoms: A Cross-Sectional Study.

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