Frequency of urinary incontinence in people with chronic heart failure

Hwang, Rita; Chuan, F.; Peters, Robyn; Kuys, Suzanne

doi:10.1016/j.hrtlng.2012.08.003

Cited by 32 publications

(30 citation statements)

References 32 publications

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“…Drug therapy in heart failure is essential for slowing disease progression and for improvement of symptoms and survival [20]. However, as a part of their modes of action or as side effects, many of these medications can iatrogenically contribute to urinary frequency, urgency, nocturia or incontinence [8, 21–23]. …”

Section: Mechanisms Underlying the Risk Of Lower Urinary Tract Symptomentioning

confidence: 99%

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Managing Therapeutic Competition in Patients with Heart Failure, Lower Urinary Tract Symptoms and Incontinence

Tannenbaum

Johnell

2013

Drugs Aging

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Up to 50 % of heart failure patients suffer from lower urinary tract symptoms. Urinary incontinence has been associated with worse functional status in patients with heart failure, occurring three times more frequently in patients with New York Heart Association Class III and IV symptoms compared with those with milder disease. The association between heart failure and urinary symptoms may be directly attributable to worsening heart failure pathophysiology; however, medications used to treat heart failure may also indirectly provoke or exacerbate urinary symptoms. This type of drug–disease interaction, in which the treatment for heart failure precipitates incontinence, and removal of medications to relieve incontinence worsens heart failure, can be termed therapeutic competition. The mechanisms by which heart failure medication such as diuretics, angiotensin-converting enzyme (ACE) inhibitors and β-blockers aggravate lower urinary tract symptoms are discussed. Initiation of a prescribing cascade, whereby antimuscarinic agents or β3-agonists are added to treat symptoms of urinary urgency and incontinence, is best avoided. Recommendations and practical tips are provided that outline more judicious management of heart failure patients with lower urinary tract symptoms. Compelling strategies to improve urinary outcomes include titrating diuretics, switching ACE inhibitors, treating lower urinary tract infections, appropriate fluid management, daily weighing, and uptake of pelvic floor muscle exercises.

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Section: Mechanisms Underlying the Risk Of Lower Urinary Tract Symptomentioning

confidence: 99%

“…Studies indicate that 35–50 % of heart failure patients suffer from urinary incontinence [8–10]. Urinary incontinence is associated with reduced functional capacity in older adults with heart failure [11].…”

Section: Introductionmentioning

confidence: 99%

Managing Therapeutic Competition in Patients with Heart Failure, Lower Urinary Tract Symptoms and Incontinence

Tannenbaum

Johnell

2013

Drugs Aging

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“…Patients may be reluctant to discuss urinary symptoms with their healthcare provider, and most patients with UI never seek treatment [5]. Thus, increasing the healthcare providers' awareness of UI and other urinary symptoms in patients with CKD or other chronic conditions in which diuretics are prescribed such as heart failure [21] may increase discussions between the patient and provider regarding urinary symptoms. Informing the patient of the side effects of diuretics and providing tactics for reducing symptoms (e.g., altering the timing of medications to avoid accidents) may increase compliance with these medications.…”

Section: Discussionmentioning

confidence: 99%

Urinary incontinence and diuretic avoidance among adults with chronic kidney disease

et al. 2016

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“…People also modify their medicine taking to fit around their lifestyle; for example, avoiding taking diuretics when finding a toilet would be inconvenient [9]. In contrast to the polypill, if each medicine is in a separate tablet, patients can change or delay the dose of one without affecting the other drugs.…”

Section: Ian G Tuckermentioning

confidence: 99%