Antihypertensive Drug Class Use and Differential Risk of Urinary Incontinence in Community-Dwelling Older Women

作者：Peron Emily P^*; Zheng Yan; Perera Subashan; Newman Anne B; Resnick Neil M; Shorr Ronald I; Bauer Douglas C; Simonsick Eleanor M; Gray Shelly L; Hanlon Joseph T; Ruby Christine M

来源：Journals of Gerontology Series A-Biological Sciences and Medical Sciences, 2012, 67(12): 1373-1378.

DOI：10.1093/gerona/gls177

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. %26lt;br%26gt;Methods. The sample consisted of 959 black and white women aged 7281 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. %26lt;br%26gt;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). %26lt;br%26gt;Conclusion. In community-dwelling older women, peripheral alpha blocker use was associated with UI, and the odds nearly doubled when used with loop diuretics.

• 出版日期2012-12