Open AccessRural vs. urban disparities in association with lower urinary tract symptoms and benign prostatic hyperplasia in ageing men, NHANES 2001–2008
Author(s) -
Egan K. B.,
Suh M.,
Rosen R. C.,
Burnett A. L.,
Ni X.,
Wong D. G.,
McVary K. T.
Publication year - 2015
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.12709
Subject(s) - medicine , lower urinary tract symptoms , odds ratio , national health and nutrition examination survey , odds , medical expenditure panel survey , population , logistic regression , demography , gerontology , urology , health care , prostate , environmental health , health insurance , cancer , sociology , economics , economic growth
Summary Objective The objective of this study was to investigate rural/urban and socio‐demographic disparities in lower urinary tract symptoms and benign prostatic hyperplasia ( LUTS / BPH ) in a nationally representative population of men. Methods Data on men age ≥40 years (N = 4,492) in the 2001‐2008 National Health and Nutrition Examination Surveys were analysed. Self‐report of physician‐diagnosed enlarged prostate and/or BPH medication use defined recognised LUTS / BPH . Urinary symptoms without BPH diagnosis/medications defined unrecognised LUTS / BPH . Rural–Urban Commuting Area Codes assessed urbanisation. Unadjusted and multivariable associations (odds ratios ( OR )) between LUTS / BPH and covariates were calculated using logistic regression. Results Recognised and unrecognised LUTS / BPH weighted‐prevalence estimates were 16.5% and 9.6%. There were no significant associations between LUTS / BPH and rural/urban status. Significant predisposing factors for increased adjusted odds of recognised and unrecognised LUTS / BPH included age, hypertension ( OR =1.4;1.4), analgesic use ( OR =1.4;1.4) and PSA level >4 ng/ mL ( OR =2.3;1.9) when adjusted for rural/urban status, race, education, income, alcohol, health insurance, health care and proton pump inhibitor ( PPI ) use (all p ≤ 0.1). Restricting to urban men only (N = 3,371), healthcare use (≥4visits/year) and PPI 's increased adjusted odds of recognised LUTS / BPH ( OR =2.0;1.6); no health insurance and <high school education decreased odds ( OR =0.5;0.6) after adjusting for variables listed above, antidepressant and calcium channel blocker use (p ≤ 0.1). Also among urban men, adjusted odds of unrecognised LUTS / BPH increased for blacks ( OR =1.9), Hispanic/Other ( OR =1.9) and income<$34,999 ( OR =1.6). Among rural men only (N = 1,121), adjusted odds of recognised and unrecognised LUTS / BPH increased for age, hypertension ( OR =1.9;1.7) and analgesic use ( OR =2.0;1.5) when adjusting for race, CRP , antidepressant and dyslipidaemic use (p ≤ 0.1). Conclusion Rural/urban status was not associated with significantly increased adjusted odds of either recognised or unrecognised LUTS / BPH .