title: Antihypertensive drug class use and differential risk of urinary incontinence in community-dwelling older women.
abstract: BACKGROUND
  Medication use is a potentially reversible cause of urinary incontinence (UI). The objective of this longitudinal cohort study was to evaluate whether self-reported UI in community-dwelling older women is associated with the use of different classes of antihypertensive agents.
  
  
  METHODS
  The sample consisted of 959 black and white women aged 72-81 years without baseline (Year 1) UI from the Health, Aging, and Body Composition Study. Use of any antihypertensive from 10 drug classes (ie, alpha blockers [central], alpha blockers [peripheral], angiotensin-converting enzyme inhibitors, angiotensin-II receptor blockers, beta blockers, calcium channel blockers, diuretics [loop], diuretics [potassium-sparing], diuretics [thiazide], and vasodilators) was determined during Year 3 in-person interviews. The number of unique antihypertensive agents used and the standardized daily dosage were also examined. Self-reported UI, operationally defined as leaking urine at least weekly during the previous 12 months, was assessed at Year 4 visits.
  
  
  RESULTS
  A total of 197 women (20.5%) reported UI at Year 4. Although any antihypertensive use, number of agents used, and standardized daily dosage at Year 3 were not associated with UI at Year 4, use of one particular drug class-peripheral alpha blockers (ie, doxazosin, prazosin, and terazosin)-was associated with fourfold greater odds of UI (adjusted odds ratio = 4.47; 95% confidence interval = 1.79-11.21; p = .0014). Further, in post hoc analyses, these odds nearly doubled in those also taking loop diuretics (adjusted odds ratio = 8.81; 95% confidence interval = 1.78-43.53; p = .0076).
  
  
  CONCLUSIONS
  In community-dwelling older women, peripheral alpha blocker use was associated with UI, and the odds nearly doubled when used with loop diuretics.
authors.affiliation: Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, 410 North 12th Street, P.O. Box 980533, Richmond, VA 23298, USA. epperon@vcu.edu
authors.forename: Emily P
authors.initials: EP
authors.lastname: Peron
authors.forename: Yan
authors.initials: Y
authors.lastname: Zheng
authors.forename: Subashan
authors.initials: S
authors.lastname: Perera
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
authors.forename: Neil M
authors.initials: NM
authors.lastname: Resnick
authors.forename: Ronald I
authors.initials: RI
authors.lastname: Shorr
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Bauer
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Simonsick
authors.forename: Shelly L
authors.initials: SL
authors.lastname: Gray
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Hanlon
authors.forename: Christine M
authors.initials: CM
authors.lastname: Ruby
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000145:classification*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D016015:Logistic Models; D018570:Risk Assessment; D014549:Urinary Incontinence / Q000139:chemically induced*
chemical_list: D000959:Antihypertensive Agents