June 30, 2005

Hypertension, old age up nighttime urination

By Alison McCook

NEW YORK (Reuters Health) - After age 60, people are more
likely to have to get up at least twice in the middle of the
night to urinate - called nocturia - if they also have high
blood pressure and take diuretics, a study shows. And the older
people get, the more likely they are to have this problem.

Although doctors often tell people with nocturia to avoid
coffee and nighttime fluids, in the current study neither
appeared to increase the risk of nocturia in older adults.

"We are very used to giving advice about caffeine intake to
deal with bladder problems," study author Dr. Theodore M.
Johnson II told Reuters Health. "While it is true that caffeine
causes an overproduction of urine and may also be a bladder
irritant, this advice may be less important in nocturia," he

Johnson, who is based at the Birmingham/Atlanta Department
of Veterans Affairs Geriatric Research Education and Clinical
Center, added that nocturia is a "symptom," not a condition,
which may result from low bladder capacity, too much urine
production at night, or a sleep disturbance.

In the Journal of the American Geriatrics Society, Johnson
and his team note that nocturia can significantly disrupt older
adults' sleep, and doubles their risk of falling.

To investigate what factors are associated with nocturia,
the researchers asked 1,632 people aged 60 and older to
estimate the number of times they usually urinate after going
to sleep at night. People were followed for several years;
anyone who said they urinated at least twice after bed was
diagnosed with nocturia.

Nearly one-third of the people who participated in the
study were diagnosed with nocturia, and a handful (1 percent)
said they had to get up at least six times every night to

Examining all variables, Johnson and his colleagues found
that having hypertension, taking diuretics, and increased age
were associated with a higher risk of nocturia.

Johnson explained that previous research has often linked
hypertension and older age to nocturia. In terms of diuretics,
he noted that it's difficult to say if they are a cause or
symptom of the problem.

Although this research does not offer much insight for how
to treat nocturia, further studies may, Johnson noted. And in
the meantime, older adults need to make sure that when they get
up to urinate, they do so safely.

"People who go to the bathroom frequently at night should
identify a clear path to the bathroom and maybe use some low
level lighting to help guide the nighttime journey," he said.

SOURCE: Journal of the American Geriatrics Society, June