Overactive Bladder is a Distress Symptom in Heart Failure

Abstract

The prevalence of Heart failure (HF) is expected to increase worldwide with the aging population trend. The numerous symptoms of and repeated hospitalizations for HF negatively affect the patient’s quality of life and increase the patient’s economic burden. Up to 50% of patients with HF suffer from urinary incontinence (UI) and an overactive bladder (OAB). However, there are limited data about the relationship between UI, OAB, and HF. The association between HF and urinary symptoms may be directly attributable to worsening HF pathophysiology. A comprehensive literature review was conducted for all publications between January 2000 and November 2017 using the PubMed, Embase, and Cochrane databases. HF represents a major and growing public health problem, with an increased risk of UI and an OAB as comorbidities. Possible effects of HF on urinary problems may be mediated by the prescription of medications for symptomatic relief. Although diuretics are typically used to relieve congestion, and angiotensin-converting enzyme inhibitors and angiotensin receptor blockers improve survival, these classes of drugs have been suggested to worsen urinary symptoms in the presence of HF. Further research is required to understand the impact of UI and an OAB on the HF illness trajectory.

Cardiovascular care of older adults

“…74 75 The high prevalence of urinary incontinence in heart failure is likely multifactorial, owing to natriuretic peptides attempting to regulate intravascular volume, heart failure medications, and overlapping risk factors for heart failure and urinary incontinence. [74][75][76] Loop diuretics are often implicated in causing urinary incontinence in patients with heart failure, but the literature is somewhat conflicting. A cross sectional, propensity matched study of 172 older adults (mean age 79 years) found diuretics to be independently associated with urinary frequency (adjusted odds ratio 3.09, 1.20 to 7.97) and urgency (2.50, 1.00 to 6.27) but not with incontinence (1.88, 0.57 to 6.16).…”

Evaluation and treatment of urinary incontinence in the aging male

“…Other risk factors for UI include memory problems, difficulty with talking and walking, mobility limitations, leg edema, and other non-UI urinary problems [40]. Patients with heart failure also have a high rate of concomitant urinary incontinence [41].…”

A Novel Alternative in the Treatment of Detrusor Overactivity? In Vivo Activity of O-1602, the Newly Synthesized Agonist of GPR55 and GPR18 Cannabinoid Receptors

“…O-1602, at the applied dose (0.25 mg/kg, intra-arterially), did not alter the mentioned parameters in a statistically significant way. This might be important, especially in the context of the frequent coexistence of OAB and cardiovascular diseases in the elderly [88][89][90][91][92][93].…”