Abstract 10138: Evening Blood Pressure and Heart Rate: An Age-Specific Association of Nocturia in the Japanese at High-Risk of Cardiovascular Disease

Abstract

Background: Earlier epidemiologic studies have reported a significant relationship between hypertension and nocturia. However, the underlying pathophysiology has not been established in relation to heart rate (HR). Hypothesis: We hypothesized that blood pressure (BP), HR, and the class of antihypertensive agent might be associated with severity of nocturia in the Japanese at high-risk of cardiovascular disease. In addition, these associations were hypothesized to be moderated by age. Methods: In the Japan Morning Surge-Home Blood Pressure Study, measurements of home BP as well as HR at evening (mean 11.2 days) were performed in the 4310 patients with one or more cardiovascular risks (64.9 years old, male 47%). A self-administered questionnaire included items on nocturia was used. Results: The mean levels of evening systolic BP (SBP) and HR were 130±15mmHg and 70±9.6bpm, respectively. According to the number of nocturia, we divided into the three groups (no void: n= 2382; one void: n=847; > 2 voids per night: n=1082). In the multinomial logistic regression analysis adjustment for confounders including age, gender, smoking, total cholesterol, fasting blood glucose, HbA1c, log B-type natriuretic peptide, beta-adrenergic blockade use, clinic SBP and clinic HR, the use of diuretics (OR, 1.23, 95%CI, 1.01-1.50, p<0.05) was significantly associated with one nocturnal void, while evening SBP (OR per 1SD, 1.14, 95%CI, 1.05-1.24, p<0.01) and evening HR (OR per 1SD, 1.12, 95%CI: 1.02-1.24, p<0.05) were significantly associated with multiple nocturnal voids. In the lower aged group (<66yrs), only evening HR remained significant (p=0.003), while only evening SBP remained significant for multiple nocturnal voids in the higher aged group (66yrs < ) (p=0.007). A significant interaction was found between age and evening HR for multiple nocturnal voids (p<0.05). Conclusions: In this study, evening SBP and evening HR were significant indicators of multiple nocturnal voids in the high-risk Japanese population. Increased evening HR was specifically associated with severe nocturia in the lower aged group. Age-stratified approach to reduce BP and HR burdens might be important to improve sleep disturbance caused by nocturia.