Toilet trips at night signal high blood pressure (hypertension): Study

by NCN Health And Science Team Posted on March 30th, 2019

Trips to the toilet at night are a sign of high blood pressure, according to results from the Watari study presented today at the 83rd Annual Scientific Meeting of the Japanese Circulation Society (JCS 2019).

“Our study indicates that if you need to urinate in the night – called nocturia – you may have elevated blood pressure and/or excess fluid in your body,” said study author Dr Satoshi Konno, of the Division of Hypertension, Tohoku Rosai Hospital, Sendai, Japan. “If you continue to have nocturia, ask your doctor to check your blood pressure and salt intake.”

JCS 2019 takes place from 29 to 31 March in Yokohama. Joint scientific sessions are being held by the European Society of Cardiology (ESC) and JCS as part of the ESC Global Activities programme.1

Previous research from Japan has reported that high salt intake is associated with nocturia.2 Compared to western countries, people in Japan eat more salt and are more likely to be “salt sensitive”, meaning that their blood pressure rises more when salt is consumed. Taken together, these two factors mean that people in Japan are at greater risk of developing high blood pressure.

This study examined the link between nocturia and hypertension in the general Japanese population. The study enrolled 3,749 residents of Watari who had an annual health check in 2017. Blood pressure was measured and information on nocturia was obtained by questionnaire. Participants with blood pressure 140/90 mmHg or higher or prescribed antihypertensive drugs were considered hypertensive.

Nocturia (one or more nocturia events per night) was significantly associated with hypertension after controlling for possible confounders (odds ratio 1.4; p<0.01). The risk of hypertension rose significantly as the number of nocturia events per night increased (p for trend <0.01).

“We found that getting up in the night to urinate was linked to a 40% greater chance of having hypertension,” said Dr Konno. “And the more visits to the toilet, the greater the risk of hypertension.”

Of the 1,882 participants who answered the questionnaire, 1,295 (69%) had nocturia. Dr Konno said the results do not prove a causal relationship between nocturia and hypertension and may not apply to populations outside Japan. He said: “The relationship may be influenced by various factors including lifestyle, salt intake, ethnicity, and genetic background.”

Dr Mutsuo Harada, press coordinator for JCS 2019, said: “Hypertension is a national disease in Japan. The average salt intake in Japan is approximately 10 g/day, which is more than double the average salt intake worldwide (4 g/day). This excessive salt intake is related to our preference for seafood and soy sauce-based food, so salt restriction is difficult to carry out. Early detection and management of hypertension are very important to prevent cardiovascular diseases. We should keep in mind that nocturia is not only caused by urinary organ problems but also by systemic diseases such as hypertension.”

ESC President Professor Barbara Casadei said: “More than one billion people have high blood pressure worldwide. High blood pressure is the leading global cause of premature death, accounting for almost ten million deaths in 2015. ESC guidelines recommend medication to reduce the risk of stroke and heart disease.3 A healthy lifestyle is also advised, including salt restriction, alcohol moderation, healthy eating, regular exercise, weight control, and smoking cessation.”

High Blood Pressure

Blood pressure is the force of blood pushing against the walls of your arteries, which carry blood from your heart to other parts of your body. Blood pressure normally rises and falls throughout the day. But if it stays high for a long time, it can damage your heart and lead to health problems. High blood pressure raises your risk for heart disease and stroke, which are leading causes of death in the United States.

High blood pressure has no warning signs or symptoms, and many people do not know they have it. The only way to know if you have it is to measure your blood pressure. Then you can take steps to control it if it is too high.

High Blood Pressure Signs and Symptoms

High blood pressure is called the “silent killer” because it often has no warning signs or symptoms, and many people do not know they have it.

Rarely, high blood pressure can cause symptoms like headaches or vomiting.

There’s only one way to know whether you have high blood pressure—have a doctor or other health professional measure it. Measuring your blood pressure is quick and painless.

Effects of High Blood Pressure

High blood pressure can damage your health in many ways. It can seriously hurt important organs like your heart and brain.

Fortunately, you can control your blood pressure to lower your risk for serious health problems.

Decreased Blood Flow to the Heart

High blood pressure can harden your arteries, which decreases the flow of blood and oxygen to your heart and lead to heart disease. In addition, decreased blood flow to the heart can cause:

  • Chest pain, also called angina.
  • Heart failure, a condition when your heart can’t pump enough blood and oxygen to your other organs.
  • Heart attack, which occurs when the blood supply to your heart is blocked and heart muscle begins to die without enough oxygen. The longer the blood flow is blocked, the greater the damage to the heart.

The Brain

High blood pressure can burst or block arteries that supply blood and oxygen to the brain, causing a stroke. Brain cells die during a stroke because they do not get enough oxygen. Stroke can cause serious disabilities in speech, movement, and other basic activities, and a stroke can kill you.

The Kidneys

Adults with diabetes, high blood pressure, or both have a higher risk of developing chronic kidney disease than those without these diseases. Approximately 1 of 3 adults with diabetes and 1 of 5 adults with high blood pressure have chronic kidney disease.

Measuring Blood Pressure

Measure your blood pressure regularly. It is quick and painless, and it is the only way to know whether your pressure is high. You can check your blood pressure at a doctor’s office, at a pharmacy, or at home.

How Blood Pressure is Measured

First, a doctor or other health professional wraps a special cuff around your arm. The cuff has a gauge on it that will read your blood pressure. The doctor then inflates the cuff to squeeze your arm.

After the cuff is inflated, the doctor will slowly let air out. While doing this, he or she will listen to your pulse with a stethoscope and watch the gauge. The gauge uses a scale called “millimeters of mercury” (mmHg) to measure the pressure in your blood vessels.

Another option is to get a blood pressure measurement from the machines available at many pharmacies. There are also home monitoring devices for blood pressure that you can use yourself.

What Blood Pressure Numbers Mean

Blood pressure is measured using two numbers. The first number, called systolic blood pressure, measures the pressure in your blood vessels when your heart beats. The second number, called diastolic blood pressure, measures the pressure in your blood vessels when your heart rests between beats.

If the measurement reads 120 systolic and 80 diastolic, you would say “120 over 80” or write “120/80 mmHg.”

The chart below shows normal, at-risk, and high blood pressure levels. A blood pressure less than 120/80 mmHg is normal. A blood pressure of 140/90 mmHg or more is too high. People with levels in between 120/80 and 140/90 have a condition called prehypertension, which means they are at high risk for high blood pressure.

Blood Pressure Levels
Normal systolic: less than 120 mmHg
diastolic: less than 80mmHg
At risk (prehypertension) systolic: 120–139 mmHg
diastolic: 80–89 mmHg
High systolic: 140 mmHg or higher
diastolic: 90 mmHg or higher

Controlling Blood Pressure

You can make changes to your lifestyle that will help you control your blood pressure. Your doctor might prescribe medications that can help you. By controlling your blood pressure, you will lower your risk for the harmful effects of high blood pressure.

Work with Your Health Care Team

Team-based care that includes you, your doctor, and other health care providers can help reduce and control blood pressure.1

If you already have high blood pressure, your doctor may prescribe medications and lifestyle changes. Lifestyle changes are just as important as medications. Follow your doctor’s instructions and stay on your medications. Do not stop taking your medications before talking to your doctor or pharmacist.

All drugs may have side effects, so talk to your doctor regularly. As your blood pressure improves, your doctor will check it often.

Make Lifestyle Changes

Lifestyle changes can help you control your blood pressure.

  • Diet. Eat a healthy diet that is:
    Low in salt (sodium), total fat, saturated fat, and cholesterol.
    High in fresh fruits and vegetables.
  • Be active. Try taking a brisk 10-minute walk 3 times a day 5 days a week.
  • Do not smoke. If you smoke, quit as soon as possible. Visit Smokefree.govExternal for tips on quitting.

These lifestyle changes for blood pressure control are similar to those for preventing high blood pressure.

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