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Updated: Apr 12, 2026
Ultrasonography of the Adult Male Urinary Tract for Urinary Functional Testing
Published on: August 14, 2019
Do lower urinary tract symptoms predict cardiovascular diseases in older men? A systematic review and meta-analysis
Iris I Bouwman1, Maarten J H Voskamp2, Boudewijn J Kollen3
1Department of General Practice, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands. iibouwman@hotmail.com.
Insights
This meta-analysis found no clear link between Lower Urinary Tract Symptoms (LUTS) and cardiovascular disease (CVD) in men. While some studies suggested a connection, the overall evidence does not support LUTS as a predictor of CVD.
Area of Science:
- Cardiology
- Urology
- Epidemiology
Background:
- Lower Urinary Tract Symptoms (LUTS) are common in men and have been anecdotally linked to cardiovascular disease (CVD).
- Previous cross-sectional studies suggested an association, but longitudinal data were lacking.
- Understanding this relationship is crucial for comprehensive patient risk assessment.
Purpose of the Study:
- To investigate the incidence of cardiovascular disease (CVD) in men at risk, comparing those with and without Lower Urinary Tract Symptoms (LUTS).
- To synthesize evidence from longitudinal studies to determine if LUTS predict CVD events or mortality.
Main Methods:
- A systematic literature search was conducted in MEDLINE, EMBASE, and the Cochrane Library Central Register from October 2013 to December 2014.
- Longitudinal studies examining the association between LUTS and CVD (mortality) were included, adhering to PRISMA criteria.
- Meta-analyses were performed on data from included studies.
Main Results:
- Five studies involving 6027 men with LUTS and 18,993 without were analyzed, with a follow-up of 5–17 years and 2780 CVD events.
- No significant association was found between LUTS and CVD in the pooled analysis (HR 1.09, 95% CI 0.90-1.31).
- Two studies on nocturia suggested a potential link to CVD mortality in specific populations, but this was not consistently found in adjusted analyses.
Conclusions:
- This meta-analysis of longitudinal studies does not support Lower Urinary Tract Symptoms (LUTS) as a predictor of cardiovascular disease (CVD) in men without a prior CVD history.
- The findings contrast with some cross-sectional studies, highlighting the need for robust longitudinal data.
- Further research may be needed to clarify the complex relationship between specific LUTS, like nocturia, and cardiovascular outcomes.
Purpose:
To study the incidence of CVD in men at risk, with and without LUTS.
Methods:
We searched all longitudinal studies describing the association between LUTS and CVD (mortality) in October 2013 and December 2014 using MEDLINE, EMBASE, and the Cochrane Library Central Register. PRISMA criteria were met.
Results:
We included five studies with 6027 men with LUTS and 18,993 men without LUTS in the meta-analyses, with a follow-up period varying from 5 to 17 years. Studies totalled 2780 CVD events. No clear association between CVD and LUTS was demonstrated [pooled effect size: hazard ratio 1.09 (95 % CI 0.90-1.31); p = 0.40]. Two other studies reported the association between nocturia and (CVD) mortality. CVD-specific mortality risk was approximately two times higher for Japanese men with nocturia (357 men aged 70 years and over, 5-year follow-up). A univariable association between nocturia and all-cause mortality was found in Dutch men, but not in age-adjusted analyses (1114 men aged 50-78 years, 13-year follow-up).
Conclusion:
This meta-analysis conducted on longitudinal studies does not confirm LUTS to be a predictor of CVD in men without a history of CVD, despite the observed association between LUTS and CVD in cross-sectional studies.
