Our publication on the use of cardiovascular medication in women and continence is published today [1]. Urinary continence in women is subject to many influences, not least age, obesity, diabetes and parity. In addition, several drugs used in cardiovascular medicine have the potential to affect continence. How should this understanding reflect on prescribing patterns?
The prevalence of urinary incontinence (UI) in women rises steadily from age 15 years onwards, with estimates for the general population of between 12–51%, to rates reaching 52% in women over 70, and 56% in women over 80 years of age. How do the apparent influence of cardioactive medications, age, diabetes and race on aspects of urinary incontinence in women?
We questioned over a thousand women attending cardiology out-patient clinics, at two west London district general hospitals, with a diagnosis of hypertension were questioned. Data on age, race, diabetes and cardio-active medications were recorded for their effects on UI. Patients with a high requirement for diuretics (>80 mg of frusemide or equivalent), were excluded. Multivariate logistic regression analyses were performed on those variables that showed some association (p<0.2) with outcomes of urinary continence on an initial univariate analysis. Age was considered on a continuous scale, with odds ratios reflecting an effect of age upon the odds of urinary continence, for any 10-year increment in age.
It was clear from our data that UI is highly prevalent in women within the age range studied. Of this relatively large sample of female patients, more than half (59%) reported issues and those not receiving cardioactive medications were less likely to suffer “any” UI and had significantly less nocturia. We concluded that the influence of cardioactive medications on female urinary continence should be recognised in much the same way as attention is paid to men, with regard to their prostate or sexual function and cardioactive medications. Women being prescribed these medications should be appropriately counselled on the potential effects these drugs may have on urinary continence.
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