The Association of Nocturia and Major Cardiovascular Events: A Bayesian Analysis

IMPORTANCE: Mixed evidence suggests that nocturia may be related to major adverse cardiovascular events (MACEs). OBJECTIVES: Our objective was to estimate the association between nocturia, quantified on bladder diaries, and MACE. STUDY DESIGN: From 2021 to 2024, the Symptoms of Lower Urinary Tract Dysfunction Research Network observational study (LURN II) enrolled participants with or without nocturia. Baseline characteristics, patient-reported outcomes, and bladder diary data were collected and joined with MACE outcomes from the electronic medical records at a single site. Participants with a diagnosis of a MACE outcome before LURN II enrollment were excluded. Estimates of the associations between the number of nocturia events, nocturia volumes, and the proportion of daily urine made at night, or nocturnal polyuria index (NPI), and ranked MACE outcomes were generated. Associations were estimated using Bayesian proportional odds ordinal models with skeptical priors. Model covariates included age and sex. RESULTS: Of the 146 participants, 10.3% developed a MACE. Median follow-up time (IQR) was 31.5 (18.7) months. The probability of an association between NPI and MACE outcomes was 98% (adjusted odds ratio [aOR], 1.01; credible interval, 1.00, 1.02). The probability of an association between the number of nocturia episodes and MACE was 84% (aOR, 1.09; credible interval, 0.93, 1.29). The probability of an association between NPI with male sex and MACEs was 0.98, and with female sex and MACEs was 0.00005 (aOR, 1.01; 95% credible interval, 1.00, 1.02). CONCLUSION: NPI, especially in males, and the number of nocturia episodes have a high probability of being associated with MACE outcomes.