Association of urological symptoms and chronic illness in men and women: contributions of symptom severity and duration--results from the BACH Survey.
OBJECTIVE
We investigated the association between lower urinary tract symptoms and chronic illness, such as heart disease, diabetes, hypertension and depression, in men and women. In addition, we determined whether a dose-response relationship exists in the association between the severity and duration of urological symptoms and major chronic illnesses.


METHODS
The Boston Area Community Health Survey used a multistage stratified design to recruit a random sample of 5,503 adults who were 30 to 79 years old. Urological symptoms in the American Urological Association symptom index were included in analysis.


RESULTS
Statistically significant associations that were consistent by gender were observed between depression and all urological symptoms. Nocturia of any degree of severity or duration was associated with heart disease in men and with diabetes in women. In men a dose-response relationship was observed for the association of symptom severity and/or the duration of urinary intermittency and frequency with heart disease, and for the association of urinary urgency with diabetes. In women a history of heart disease was associated with a weak stream and straining, while a history of hypertension was associated with urgency and a weak stream.


CONCLUSIONS
Results indicate a dose-response relationship in the association of the severity and duration of urological symptoms with major chronic illnesses. An association between urinary symptoms and depression was observed in men and women. In contrast, the association between lower urinary tract symptoms and heart disease, diabetes or hypertension varied by gender, suggesting different mechanisms of association in men and women.
Kupelian
Varant
V
New England Research Institutes, Watertown, Massachusetts 02472, USA. vkupelian@neriscience.com
Rosen
Raymond C
RC
Link
Carol L
CL
McVary
Kevin T
KT
Aiyer
Lalitha Padmanabhan
LP
Mollon
Patrick
P
Kaplan
Steven A
SA
McKinlay
John B
JB
D000328:Adult; D017677:Age Distribution; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011336:Probability; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000453:epidemiology*; D014555:Urination Disorders / Q000175:diagnosis / Q000453:epidemiology*; D014570:Urologic Diseases / Q000175:diagnosis / Q000453:epidemiology