Increase of Framingham cardiovascular disease risk score is associated with severity of lower urinary tract symptoms

Abstract

ObjectiveTo determine the relationship between lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) and 10-year risk of cardiovascular disease (CVD) assessed by the Framingham CVD risk score in a cohort of patients without previous episodes of stroke and/or acute myocardial infarction. Patients and MethodsFrom September 2010 to September 2014, 336 consecutive patients with BPH-related LUTS were prospectively enrolled. The general 10-year Framingham CVD risk score, expressed as percentage and assessing the risk of atherosclerotic CVD events, was calculated for each patient. Individuals with low risk had ≤10% CVD risk at 10 years, with intermediate risk 10-20% and with high risk ≥20%. Logistic regression analyses were used to identify variables for predicting a Framingham CVD risk score of ≥10% and moderate-severe LUTS (International Prostate Symptom Score [IPSS] ≥8), adjusted for confounding factors. ResultsAs category of Framingham CVD risk score increased, we observed higher IPSS (18.0 vs 18.50 vs 19.0; P < 0.05), high IPSS-voiding (6.0 vs 9.0 vs 9.5; P < 0.05) and worse sexual function. Prostate volume significantly increased in those with intermediate-vs low-risk scores (54.5 vs 44.1 mL; P < 0.05). Multivariate logistic regression analysis showed that intermediate-[odds ratio (OR) 8.65; P < 0.01) and high-risk scores (OR 1.79; P < 0.05) were independently associated with moderate-severe LUTS. At age-adjusted logistic regression analysis, moderate-severe LUTS was independently associated with Framingham CVD risk score of ≥10% (OR 5.91; P < 0.05). ConclusionOur cross-sectional study in a cohort of patients with LUTS-BPH showed an increase of more than five-fold of having a Framingham CVD risk score of ≥10% in men with moderate-severe LUTS.

Relation Between Bladder Outlet Obstruction and Systemic Vascular Endothelial Dysfunction in the Male. A Preliminary Study.

“…This is suggested by the elevated values of ΕΤ-1, IL-6. Secondary, the sevenfold increase in the likelihood of BOO in coronary patients suggests a possible connection between the two pathological situations, result also seen in a recent review (Russo et al, 2015). Endothelial inflammation may cause endothelial dysfunction and is a risk factor for heart disease.…”

“…The mean IPSS score was 14.7±6.9 and the mean IPSS Quality index was 3.7±1.3. According to the IPSS grading, as shown in Table 3, more than half of the patients had moderately severe symptoms (range [8][9][10][11][12][13][14][15][16][17][18][19]. As mentioned in Patients and Methods, the participants had laboratory measurements of total plasma cholesterol, triglycerides, HDL and LDL, and the Atheromatous Index (A.I.).…”

No evidence (yet) to support the statement ‘lower urinary tract symptoms (LUTS) – an independent risk factor for cardiovascular disease (CVD)’

“…In a recent volume of this journal, the possible association between LUTS and cardiovascular disease (CVD) was highlighted [1,2]. This topic is of interest with an ageing population.…”

“…Russo et al [1] studied the association between LUTS and CVD, by means of calculating the general 10-year Framingham CVD risk score for men with different LUTS severity, assessed with the IPSS. From their analyses, the association was apparent.…”

Benign prostatic hyperplasia and metabolic syndrome: the expanding evidences of a new disease of aging male

“…In a recent cross-sectional study in a cohort of patients with BPH/LUTS, it has been demonstrated an increase of more than 5-fold of having a Framingham risk score 10% in men with moderate-severe LUTS [13].…”