Vascular Aging and Bladder Health: Associations Between Peripheral Arterial Disease and Lower Urinary Tract Symptoms in Mid-Life Women from CARDIA-PLUS
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Objectives
To describe associations between peripheral arterial disease (PAD) and bladder health (BH) and lower urinary tract symptoms (LUTS) among a subset of women in the Coronary Artery Risk Development In Young Adults (CARDIA) study.
Methods
Women from CARDIA at Birmingham, AL and Minneapolis, MN were eligible if they completed a questionnaire about bladder symptoms in 2022-23, an ancillary study post-year 35 called CARDIA-PLUS, including the global BH scale (possible range, 0-100) and the LURN-SI 10 (0-38) and the AUASI (0-35). A subset (n=216) completed an inperson examination, including the ankle brachial index (ABI) procedure (n=194). ABI scores were clinically categorized as normal (1.00-1.40), borderline abnormal (0.91-0.99), and abnormal (≤0.90; evidence of PAD). Continuous BH and LUTS variables were regressed on ABI category, adjusting for sociodemographics, obstetric/gynecologic variables, co-morbidities, and physical activity.
Key Results
Among women who completed BH/LUTS questionnaires and the ABI (n=192), the mean age was 63±4 years and racial composition was 47% Black and 53% White. ABI results were normal (74%), borderline abnormal (20%), and abnormal (6%). After adjusting for covariates, women with abnormal ABI scores had higher LURN-SI scores (4.1 points, 95% CI 0.7, 7.5) and did not have higher AUASI scores (1.4 points, 95% CI −3.1, 5.7) or lower BH scores (−9.6 points, 95% CI −24.0, 4.9) compared to women with normal ABI scores. Borderline abnormal ABI was not associated with BH or LUTS.
Discussion/Conclusion
In this cohort, PAD was associated with greater LUTS severity. PAD and LUTS may share common etiologies and risk factors that need additional research.
