Increase of Framingham cardiovascular disease risk score is associated with severity of lower urinary tract symptoms

Objective To determine the relationship between lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) and 10year risk of cardiovascular disease (CVD) assessed by the Framingham CVD risk score in a cohort of patients without previous episodes of stroke and/or acute myocardial infarction. Patients and Methods FromSeptember2010toSeptember2014,336consecutive patientswithBPH-relatedLUTSwereprospectivelyenrolled. Thegeneral10-yearFraminghamCVDriskscore,expressedas percentageandassessingtheriskofatheroscleroticCVDevents, wascalculatedforeachpatient.Individualswithlowriskhad ≤10%CVDriskat10 years,withintermediaterisk10–20%and withhighrisk≥20%.Logisticregressionanalyseswereusedto identifyvariablesforpredictingaFraminghamCVDriskscore of≥10%andmoderate–severeLUTS(InternationalProstate SymptomScore[IPSS]≥8),adjustedforconfoundingfactors. Results As category of Framingham CVD risk score increased, we observed higher IPSS (18.0 vs 18.50 vs 19.0; P<0.05), high IPSS–voiding (6.0 vs 9.0 vs 9.5; P<0.05) and worse sexual function. Prostate volume significantly increased in those with intermediate- vs low-risk scores (54.5 vs 44.1 mL; P<0.05). Multivariate logistic regression analysis showed that intermediate- [odds ratio (OR) 8.65; P<0.01) and high-risk scores (OR 1.79; P<0.05) were independently associated with moderate–severe LUTS. At age-adjusted logistic regression analysis, moderate–severe LUTS was independently associated with Framingham CVD risk score of ≥10% (OR 5.91; P<0.05). Conclusion Our cross-sectional study in a cohort of patients with LUTS– BPH showed an increase of more than five-fold of having a Framingham CVD risk score of ≥10% in men with moderate–severe LUTS.