Are lower urinary tract symptoms associated with cardiovascular disease in the Dutch general population? Results from the Krimpen study

To describe the association between lower urinary tract symptoms (LUTS) and cardiovascular diseases (CVD), with adjustment for age and other confounders. We were specifically interested in the possible predictive value of LUTS to the incidence of CVD in the future in the general population. We performed post hoc analyses using data from the Krimpen study, a large community-based study in the Netherlands. All men aged 50-75 years, without prostate or bladder cancer, a history of radical prostatectomy, or neurogenic bladder disease, were invited to participate for a response rate of 50 %. At baseline, 1,610 men were included. CVD status was compared to LUTS category, using logistic regression, providing odds ratios with 95 % confidence intervals (OR 95 % CI). For the longitudinal analyses in men without CVD at baseline, hazard ratios (HR) and 95 % CI were estimated using Cox proportional hazard models with the occurrence of a CVD as outcome variable. At baseline, 362 men (22 %) had a history of CVD. The ORs for CVD for men with moderate to severe LUTS were 2.04 (unadjusted, 95 % CI 1.58-2.63), 1.86 (1.43-2.41, adjusted for age), and 1.81 (1.38-2.37, adjusted for age and other confounders). Of the 1,248 CVD-free men, 58 (4.6 %) had a CVD event. HRs for moderate to severe LUTS were 0.98 (95 % CI 0.52-1.86, unadjusted) and 1.08 (0.57-2.07, adjusted for age, obesity, hypertension, and erectile dysfunction). The cross-sectional analyses revealed a clear correlation between moderate to severe LUTS and CVD. In longitudinal analyses, however, no significant association was shown.