title: Do lower urinary tract symptoms predict cardiovascular diseases in older men? A systematic review and meta-analysis.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of General Practice, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands. iibouwman@hotmail.com.
authors.forename: Iris I
authors.initials: II
authors.lastname: Bouwman
authors.affiliation: Department of Urology, University Medical Center Groningen, Groningen, The Netherlands. maartenvoskamp@gmail.com.
authors.forename: Maarten J H
authors.initials: MJ
authors.lastname: Voskamp
authors.affiliation: Department of General Practice, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands. b.j.kollen@umcg.nl.
authors.forename: Boudewijn J
authors.initials: BJ
authors.lastname: Kollen
authors.affiliation: Department of Urology, University Medical Center Groningen, Groningen, The Netherlands. j.m.nijman@umcg.nl.
authors.forename: Rien J M
authors.initials: RJ
authors.lastname: Nijman
authors.affiliation: Department of General Practice, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands. w.k.van.der.heide@umcg.nl.
authors.forename: Wouter K
authors.initials: WK
authors.lastname: van der Heide
authors.affiliation: Department of General Practice, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands. blanker@belvederelaan.nl.
authors.forename: Marco H
authors.initials: MH
authors.lastname: Blanker
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D059411:Lower Urinary Tract Symptoms / Q000150:complications*; D008297:Male
keywords: Ageing male; Cardiovascular diseases; Lower urinary tract symptoms; Systematic review/meta-analysis