Relationship Between Heart Failure and Overactive Bladder

Abstract

The prevalence of heart failure and overactive bladder, both of which are already quite common, will continue to increase as the population ages. Both create caregiver and self-management burdens, but additional research is needed to understand the burden overactive bladder creates for heart failure patients and their caregivers. Emerging evidence suggests a relationship between heart failure and overactive bladder in which they share a common pathophysiologic pathway via the parasympathetic system. The authors conducted a systematic literature review of overactive bladder in heart failure patients from 2007 to the present. Conflicting evidence exists for the role diuretics play in the prevalence of overactive bladder. Further research is needed to better understand the role of heart failure disease trajectory and its medical management in the natural history of overactive bladder.

Receipt of Overactive Bladder Drugs and Incident Dementia: A Population-based Case-control Study

“…Stress urinary incontinence develops with age owing to deficits in urethral pressure (110), pelvic floor disorders (111), and increased body mass index (112). Other phenomena that may impact the prevalence of OAB with dementia include comorbidities such as diabetes mellitus (113), congestive heart failure (114), and bladder outlet obstruction. Nocturnal polyuria is also prevalent with age, possibly the result of other comorbidity such as congestive heart failure, but it may also be related to stroke and the regulation of arginine vasopressin (AVP) neurons in of hypothalamic region of the brain.…”

Interest in Information About Urinary Incontinence Among Diabetic and Nondiabetic Heart Failure Patients

“…In fact, a growing body of literature strongly suggests that HF patients are susceptible to UI. 1,5,18 Thus, health care providers should be knowledgeable about comorbidities commonly associated with HF, particularly UI, so these individuals can be identified, assessed, and provided the necessary resources to promote urinary continence.…”

“…Research supports a common pathophysiologic pathway involving the parasympathetic nervous system is shared by HF and UI. 5 Pharmacological therapies such as loop diuretics that are often used in treatment of HF have been reported to provoke UI or exacerbate preexisting incontinence. 5,6 Coupled with another comorbidity such as DM, which is often prevalent in HF patients, this can make overall management very difficult for both the patient and the provider.…”

“…5 Pharmacological therapies such as loop diuretics that are often used in treatment of HF have been reported to provoke UI or exacerbate preexisting incontinence. 5,6 Coupled with another comorbidity such as DM, which is often prevalent in HF patients, this can make overall management very difficult for both the patient and the provider. Multiple studies have associated UI and DM, 7-10 but we identified only 1 study focusing on interrelationships among UI, DM, and HF.…”

Overactive Bladder is a Distress Symptom in Heart Failure

“…Heart failure (HF) is a complex clinical syndrome characterized by the reduced ability of the heart to pump and/or fill with blood [ 1 ]. HF has been defined as a global pandemic, since it affects around 26 million people worldwide [ 2 ]. The prevalence of HF is expected to rise because of the aging population, improvements in the treatment of diagnosed HF, and marked increases in the prevalence of predisposing risk factors such as hypertension and diabetes [ 1 ].…”