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Bladder leakage and Blood Pressure: an important connection for heart health.

Did you know that high blood pressure and urinary incontinence (leaking urine) are related?  New research has been published about the connection between high blood pressure (hypertension) and urinary incontinence.  In honor of National Hearth Health Awareness month, we wanted look at this research more closely, and share it with you. 

The first article published in 2022 (Association of Overactive Bladder With Hypertension and Blood Pressure control: The Multi-Ethnic Study of Atherosclerosis (MESA)) looks specifically at urge incontinence, overactive bladder, and high blood pressure.  The researchers found that men and women with overactive bladder tend to have higher blood pressure.  They also found in men specifically, a strong correlation between urinary symptoms and blood pressure control; meaning, the more urinary symptoms a patient has, the harder it is to control the patient’s blood pressure with medication. The study looks at several potential causes for this: 

– Urinary symptoms and blood pressure are both affected by obesity and exercise.  So, both the blood pressure and incontinence could be related to shared risk factors, rather than a common cause. 

– Another potential cause could be the fact that people with overactive bladder tend to have increased sensitivity to bladder filling.  This sensitivity can increase activity of their sympathetic nervous system (fight or flight).  Increased activity in the sympathetic nervous system is highly correlated with high blood pressure.  This is why your blood pressure may be higher if you get it checked with a full bladder versus when you have just gone to the bathroom. 

– Urinary incontinence can also lead to distress, which may lead to increased blood pressure due to anxiety and greater social isolation.  The researchers suggest that overactive bladder or urge incontinence may be an important factor to consider when looking at high blood pressure management and to improve hearth health.   

The second article published in 2023 (Urinary incontinence and cardiovascular disease: a narrative review | International Urogynecology Journal ( looked at the association between all types of urinary incontinence and heart health.  There are studies that show urinary incontinence is associated with increased early mortality. This research focuses on the overlap of incontinence and cardiovascular health.  There is a strong overlap of risk factors that can affect bladder and heart health.  This includes:

– obesity
– smoking
– diabetes
– high blood pressure 

With the overlap of high blood pressure, urinary incontinence, and diabetes, the researchers argue that urinary incontinence may be a consequence of metabolic syndrome.  Similarly, to the other study, the researchers encourage patients experiencing urinary incontinence to be screened for cardiovascular health due to the strong overlap of mortality.   

If you or someone you love is having urinary incontinence, it is important for them to talk to their primary health care provider.  Ask the right questions. It may not just be urinary leaking. There may be concerns of high blood pressure or other heart or metabolic issues. At Foundational Concepts we offer a free 15 minute phone consultation to answer questions and make sure you are receiving the care you need. We also take a very integrative approach to pelvic health and will help ensure you don’t miss important health and wellness signs that should be addressed. Leaking urine impacts quality of life tremendously. Do not just live with it. It is quite easily addressed in pelvic floor physical therapy, we are here to help!

Sarah is the proud co-owner of Foundational Concepts, Specialty Physical Therapy which opened in March 2013. Sarah lectures at the University of Missouri Department of PT, University of Kansas Departments of PT and Nurse Midwifery, and at Rockhurst University Department of PT. She is board certified in Women’s Health PT and holds certifications in medical therapeutic yoga, lymphedema therapy and dry needling.

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