title: Autonomic dysfunction and arterial stiffness in female overactive bladder patients and antimuscarinics related effects.
abstract: OBJECTIVE
  To investigate the characteristics of autonomic function and arterial stiffness of OAB women, their relations with urodynamic parameters, and the impact of antimuscarinics on the above parameters.
  
  
  METHODS
  A total of 85 OAB women and another 65 women without OAB were selected. Forty-two OAB women who enrolled before March 2009 were treated with tolterodine for 12 weeks, and another 43 OAB women who enrolled thereafter were treated with solifenacin.
  
  
  METHODS
  The differences of the heart rate variability, cardio-ankle vascular index (CAVI) and ankle-brachial pressure index (ABI) between OAB and asymptomatic women, and their changes after 12 weeks' antimuscarinics for OAB women.
  
  
  RESULTS
  OAB women had higher low frequency/high frequency ratios (LF/HF) (OAB: 1.5±1.1 vs. the control: 1.1±0.7, P=0.04). Nonetheless, CAVI and ABI did not differ between OAB and the control group. The square root of the mean squared differences of successive NN intervals (RMSSD) is associated with nocturia (Spearman's ρ=0.23, P=0.049), LF is associated with urgency episodes (Spearman's ρ=0.28, P=0.01), and maximum urethral closure pressure is negatively associated with CAVI (Spearman's ρ=-0.26, P=0.02). After 12 weeks' treatment, a decrease of RMSSD, HF, CAVI and an increase of LF/HF were found in the tolterodine group but not in the solifenacin group.
  
  
  CONCLUSIONS
  OAB women have higher severity of autonomic dysfunction with sympathetic predominance. Tolterodine may improve arterial stiffness but may deteriorate autonomic dysfunction to more sympathetic predominance. Thus, tolteridine should be used for OAB with caution in women with preexisting symptoms of autonomic dysfunction.
authors.affiliation: Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan.
authors.forename: Sheng-Mou
authors.initials: SM
authors.lastname: Hsiao
authors.affiliation: Department of Internal Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ta-Chen
authors.initials: TC
authors.lastname: Su
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chi-Hau
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ting-Chen
authors.initials: TC
authors.lastname: Chang
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: hhlin@ntuh.gov.tw.
authors.forename: Ho-Hsiung
authors.initials: HH
authors.lastname: Lin
mesh_terms: D000328:Adult; D055109:Ankle Brachial Index; D001794:Blood Pressure / Q000187:drug effects; D015716:Electrocardiography, Ambulatory / Q000379:methods; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D053158:Nocturia / Q000188:drug therapy; D011312:Pressure; D000069464:Solifenacin Succinate / Q000627:therapeutic use; D000068737:Tolterodine Tartrate / Q000627:therapeutic use; D014521:Urethra / Q000187:drug effects; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*; D014549:Urinary Incontinence / Q000188:drug therapy; D014554:Urination / Q000187:drug effects; D014563:Urodynamics / Q000187:drug effects; D059289:Vascular Stiffness / Q000187:drug effects*
chemical_list: D018727:Muscarinic Antagonists; D000068737:Tolterodine Tartrate; D000069464:Solifenacin Succinate
keywords: Ankle-brachial pressure index; Antimuscarinics; Arterial stiffness; Autonomic function; Overactive bladder syndrome