Autonomic dysfunction and arterial stiffness in female overactive bladder patients and antimuscarinics related effects
Journal
Maturitas
Journal Volume
79
Journal Issue
1
Pages
65-69
Date Issued
2014
Author(s)
Abstract
Objectives To investigate the characteristics of autonomic function and arterial stiffness of OAB women, their relations with urodynamic parameters, and the impact of antimuscarinics on the above parameters. Study design A total of 85 OAB women and another 65 women without OAB were selected. Forty-two OAB women who enrolled before March 2009 were treated with tolterodine for 12 weeks, and another 43 OAB women who enrolled thereafter were treated with solifenacin. Main outcome measures The differences of the heart rate variability, cardio-ankle vascular index (CAVI) and ankle-brachial pressure index (ABI) between OAB and asymptomatic women, and their changes after 12 weeks' antimuscarinics for OAB women. Results OAB women had higher low frequency/high frequency ratios (LF/HF) (OAB: 1.5 ± 1.1 vs. The control: 1.1 ± 0.7, P = 0.04). Nonetheless, CAVI and ABI did not differ between OAB and the control group. The square root of the mean squared differences of successive NN intervals (RMSSD) is associated with nocturia (Spearman's ρ = 0.23, P = 0.049), LF is associated with urgency episodes (Spearman's ρ = 0.28, P = 0.01), and maximum urethral closure pressure is negatively associated with CAVI (Spearman's ρ = -0.26, P = 0.02). After 12 weeks' treatment, a decrease of RMSSD, HF, CAVI and an increase of LF/HF were found in the tolterodine group but not in the solifenacin group. Conclusions OAB women have higher severity of autonomic dysfunction with sympathetic predominance. Tolterodine may improve arterial stiffness but may deteriorate autonomic dysfunction to more sympathetic predominance. Thus, tolteridine should be used for OAB with caution in women with preexisting symptoms of autonomic dysfunction. ? 2014 Elsevier Ireland Ltd.
SDGs
Other Subjects
solifenacin; tolterodine; muscarinic receptor blocking agent; solifenacin; tolterodine; adult; ankle brachial index; arterial stiffness; article; asymptomatic disease; autonomic dysfunction; controlled study; disease exacerbation; disease severity; drug effect; female; heart rate variability; human; major clinical study; middle aged; outcome assessment; overactive bladder; pulse wave; sympathetic function; treatment duration; urethra pressure; urodynamics; ambulatory electrocardiography; arterial stiffness; blood pressure; comparative study; drug effects; heart rate; micturition; nocturia; pressure; procedures; urethra; Urinary Bladder, Overactive; Urinary Incontinence; Adult; Ankle Brachial Index; Blood Pressure; Electrocardiography, Ambulatory; Female; Heart Rate; Humans; Middle Aged; Muscarinic Antagonists; Nocturia; Pressure; Solifenacin Succinate; Tolterodine Tartrate; Urethra; Urinary Bladder, Overactive; Urinary Incontinence; Urination; Urodynamics; Vascular Stiffness
Publisher
Elsevier Ireland Ltd
Type
journal article