Karl-Erik Andersson led the peer-review process as the Associate Editor responsible for the paper.
The effect of angiotensin inhibition on urinary incontinence: Data from the national health and nutrition examination survey (2001–2008)
Version of Record online: 29 AUG 2013
© 2013 Wiley Periodicals, Inc.
Neurourology and Urodynamics
Volume 33, Issue 8, pages 1178–1181, November 2014
How to Cite
Elliott, C. S. and Comiter, C. V. (2014), The effect of angiotensin inhibition on urinary incontinence: Data from the national health and nutrition examination survey (2001–2008). Neurourol. Urodyn., 33: 1178–1181. doi: 10.1002/nau.22480
- Issue online: 13 OCT 2014
- Version of Record online: 29 AUG 2013
- Manuscript Accepted: 16 JUL 2013
- Manuscript Received: 30 APR 2013
Local renin–angiotensin systems exist within the genitourinary tract, specifically in the bladder and urethra. Experimental data suggest that angiotensin receptor blockade with either angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) decreases both detrusor overactivity and urethral sphincter tone leading to decreased urge incontinence (UUI) and increased stress urinary incontinence (SUI). This has not been examined in a human population.
Data from the National Health and Nutrition Examination Survey (NHANES) was accessed for the years 2001–2008. Multivariate logistic regression was used for modeling.
We studied 8,754 females and 8,886 males who met inclusion criteria. Use of ACE inhibitors or ARBs was not associated with a change in SUI in either men or women. In men, use of an ACE inhibitor or ARB was associated with a statistically significant 25–30% decrease in UUI (monthly or any urge incontinence). A similar, albeit non-significant trend was also seen for daily and weekly UUI. Other antihypertensive medications (diuretics, beta-blockers, calcium-channel blockers) were not associated with a decrease in UUI. In subanalysis, duration of ACE inhibitor or ARB use did not alter the strength of the effect on UUI nor did an elevated prostate specific antigen (PSA) level (used as a surrogate for bladder outlet obstruction due to benign prostatic hypertrophy). ACE inhibitor and ARB use did not affect UUI rates in women, though did show a trend for improvement in nulliparous women without SUI.
Angiotensin receptor blockade may be a viable treatment approach for the treatment of UUI, especially in men. Neurourol. Urodynam. 33:1178–1181, 2014. © 2013 Wiley Periodicals, Inc.