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The Association of Nocturia and Major Cardiovascular Events: A Bayesian Analysis
Annika Sinha1, Jasmine Arrington2, Aya Bashi2
1Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Reconstructive Surgery.
Urogynecology (Philadelphia, Pa.)
|February 19, 2026
Summary
Nocturia, particularly the nocturnal polyuria index (NPI), is linked to major adverse cardiovascular events (MACEs). This study found a high probability of association, especially in males, highlighting nocturia as a potential cardiovascular risk factor.
Area of Science:
- Cardiology
- Urology
- Epidemiology
Background:
- Existing research presents mixed evidence regarding the link between nocturia (frequent nighttime urination) and major adverse cardiovascular events (MACEs).
- Quantifying nocturia using bladder diaries may offer a more precise method to assess its association with cardiovascular health.
- Understanding this relationship is crucial for identifying potential cardiovascular risk factors and improving patient outcomes.
Purpose of the Study:
- To investigate and quantify the association between nocturia, as measured by bladder diary data, and the occurrence of MACEs.
- To specifically examine the role of the nocturnal polyuria index (NPI) and the number of nocturia episodes in predicting MACEs.
- To explore potential sex-based differences in the association between nocturia and MACEs.
Main Methods:
- An observational study (LURN II) enrolled 146 participants from 2021-2024, collecting baseline data, patient-reported outcomes, and bladder diary information.
- MACE outcomes were tracked via electronic medical records, excluding participants with pre-existing MACE diagnoses.
- Bayesian proportional odds ordinal models were employed to estimate associations between nocturia metrics (number of episodes, NPI) and MACEs, adjusting for age and sex.
Main Results:
- 10.3% of participants experienced a MACE during a median follow-up of 31.5 months.
- A high probability (98%) of association was found between the nocturnal polyuria index (NPI) and MACE outcomes (aOR, 1.01).
- The number of nocturia episodes showed an 84% probability of association with MACEs (aOR, 1.09). The association between NPI and MACEs was particularly strong in males (98% probability).
Conclusions:
- The nocturnal polyuria index (NPI), particularly in males, and the frequency of nocturia episodes are likely associated with an increased risk of MACEs.
- Nocturia, especially when quantified by NPI, may serve as a significant indicator for cardiovascular risk.
- Further research is warranted to elucidate the mechanisms underlying the link between nocturia and cardiovascular events.
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