Abstract 090: Nocturia as an Unrecognized Symptom of Uncontrolled Hypertension in Middle-age Black Men

Hypertension (HTN) is assumed to be asymptomatic (“the silent killer”). Yet nocturia - awakening at night to urinate - is bothersome if occurring > 2 times/night and constitutes a putative but understudied symptom of HTN. Hypertensive black men may be especially prone to nocturia due to high sodium diet, blunted nocturnal blood pressure (BP) dipping (driving pressure-natriuresis), diuretic BP drugs, and common comorbid determinants of nocturia (prostate disease, diabetes, sleep apnea). To test if uncontrolled HTN is an independent, common, and potentially reversible determinant of nocturia in black men, we conducted in-person structured interviews and measured BP with a highly-rated automated monitor (that took 5 readings and averaged the last 3) in a large community-based sample of black men in their barbershops, a uniquely relaxed social setting to obtain high participation and accurate out-of-office BP. As nocturia is steeply age-dependent, we studied younger men ages 35 to 49 Y in whom nocturia would be unexpected. Among 1,748 black men, mean age 43±4 (SD) years, 45% (782 of 1748) had HTN; of these, HTN was: controlled with drugs (barbershop BP 2 episodes/night vs. 0-1) was: (1) 34% higher in men with untreated HTN (BP 143±11/87±10): adjusted odds ratio (aOR) 1.34 (95% confidence intervals [CI]: 1.04-1.71, p=.02); (2) 174% higher in men with treated but uncontrolled HTN (BP 148±14/91±11): aOR 2.74 (95% CI:1.97-3.82, p