Abstract P155: Phenotyping The Association Between Nocturia And Hypertension: A Systematic Review And Meta-analysis

Abstract

Introduction: The association between nocturia and hypertension has been widely reported, yet remains poorly characterized, precluding a more refined understanding of blood pressure as it relates to the clinical urology setting. We synthesized current evidence on the relationship between nocturia and hypertension as a function of nocturia severity, age, sex, race, and diuretic use. Methods: We searched PubMed, EMBASE, and Cochrane databases for studies published up to May 2020. Random effects meta-analyses were performed to identify the pooled odds ratio (OR) for nocturia given the presence of hypertension. Meta-regression and subgroup analyses were performed to identify differences across demographic factors. We applied the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies to evaluate the quality of evidence. Results: Of 1530 identified studies, 23 met the criteria for inclusion. The overall pooled OR for the association of hypertension with nocturia was 1.26 (95% CI 1.22-1.29, p<0.001). Pooled estimates were 1.21 (1.16-1.25, p<0.001) and 1.31 (1.26-1.36, p<0.001) using a 1- and 2-void cutoff for nocturia, respectively (p<0.001 between cutoffs). The association was stronger in females compared to males (1.41 [1.29-1.53] vs. 1.26 [1.20-1.32], p<0.001), and in African-American (1.56 [1.25-1.94]) and Asian (1.28 [1.24-1.32]) versus Caucasian populations (1.16 [1.09-1.24]) (p<0.05for both). Age and diuretic use had no observable effect on the association between nocturia and hypertension. Conclusions: There exists an increased odds of nocturia in hypertensive individuals. This association is stronger following a higher nocturia cutoff, in females, and in some racial subgroups, but unrelated to age and diuretic utilization.