Association of Urological Symptoms and Chronic Illness in Men and Women: Contributions of Symptom Severity and Duration—Results From the BACH Survey

Abstract

The objectives of this study were to: 1) investigate the association between lower urinary tract symptoms (LUTS) and chronic illnesses such as heart disease, diabetes, hypertension, and depression in men and women, and 2) to determine whether a dose-response relationship exists in the association between the severity and duration of urologic symptoms and major chronic illnesses. The Boston Area Community Health (BACH) Survey used a multistage stratified design to recruit a random sample of 5,503 adults age 30-79. Urologic symptoms comprising the American Urological Association symptom index were included in the analysis. Statistically significant associations, consistent by gender, were observed between depression and all urologic symptoms. Nocturia of any degree of severity or duration was associated with heart disease among men and with diabetes among women. Among men, a dose-response relationship was observed in the association of symptom severity and/or duration of urinary intermittency and frequency with heart disease, and in the association of urinary urgency with diabetes. Among women, a history of heart disease was associated with weak stream and straining, while a history of hypertension was associated with urgency and weak stream. Results indicate a dose-response relationship in the association of both severity and duration of urologic symptoms with major chronic illnesses. An association between urinary symptoms and depression was observed in both men and women. In contrast, the association between LUTS and heart disease, diabetes, or hypertension varied by gender, suggesting different mechanisms of association in men and women.