Urinary incontinence linked to higher cardiovascular disease risk

Urinary incontinence linked to higher cardiovascular disease risk | Image Credit: © Syda Productions - © Syda Productions - stock.adobe.com.

The risk of cardiovascular disease (CVD) is increased in women with urinary incontinence, according to a recent study published in Preventive Medicine on April 3, 2025.¹

Approximately 38% to 60% of women are impacted by urinary incontinence, defined as a loss of bladder control. These conditions often lead to decreased physical activity, which is associated with CVD. However, while the recent data did not find reduced physical activity in women with urinary incontinence, these patients remained at a higher risk of CVD.¹

“Women should be screened for incontinence regularly as it may contribute to CVD risk, and women with CVD risk factors should be screened for undiagnosed incontinence,” wrote study authors.¹

Role of physical activity in reducing cardiovascular risk

The efficacy of physical activity toward lowering cardiovascular risk in women has been proven in prior research, including a 2024 study published in the Journal of British Medicine.² The trial focused on the impact of short bursts of physical activity, referred to as vigorous intermittent lifestyle physical activity (VILPA), on cardiovascular outcomes.

Short bouts of physical activity were those lasting up to 2 minutes. To improve the assessment of VILPA frequency, this was length-standardized to 1 minute. Major adverse cardiovascular events (MACE) were defined as “death or incidence of ST-elevated or non-ST-elevated myocardial infarction.”²

Dose-dependent links with MACE, myocardial infarction, and heart failure were only reported in women, with a hazard ratio (HR) of 0.55 for MACE in those with median daily VILPA. For heart failure, the HR was 0.33.²

Only myocardial infarction was reduced by the minimum daily doses, with an HR of 0.67. Overall, the data highlighted improved MACE outcomes from VILPA in women.²

Evaluating urinary incontinence and physical activity

The recent retrospective observational study was conducted to evaluate the link between urinary incontinence with reduced moderate-to-vigorous physical activity (MVPA) and CVD risk.³ MVPA was self-reported using the Exercise Vital Sign, while International Classification of Diseases, Tenth Revision codes were used to identify CVD.

Demographic information was also collected. The data spanned from July 2022 to June 2024 and included patients residing in Connecticut. Over 20,000 female individuals within the Hartford Healthcare system were included in the analysis.¹

Participants completed a questionnaire rating their level of physical activity. The link between urinary incontinence and MVPA was assessed through multinomial logistic regression, while correlations of urinary incontinence and CVD risk factors were assessed through logistic regression models.³

Adjustments were made for race, age, tobacco use, and body mass index. There were 20,155 women aged a mean 50.36 ± 16.42 years included in the final analysis, 5.4% of whom were diagnosed with urinary incontinence.³

Findings on cardiovascular risk factors

No differences were reported in MVPA odds between women with and without urinary incontinence. However, the risk of type 2 diabetes was increased among the latter group, with an adjusted odds ratio (aOR) of 1.25.³

Dyslipidemia, stroke, and coronary artery bypass graft risks were also increased among this population, with aORs of 1.37, 1.55, and 3.17, respectively. This highlighted an increased risk of inactivity-related CVD risk factors and cardiometabolic comorbid conditions among patients with urinary incontinence despite no changes in MVPA.³

“Future studies should investigate potential mechanisms of this association, including incontinence severity, activity intensity, and chronic inflammation,” wrote investigators.³

1. Researchers report association between urinary incontinence, cardiovascular disease. University of Iowa. April 16, 2025. Accessed April 23, 2025. https://www.eurekalert.org/news-releases/1080790.
2. Krewson C. Cardiovascular risk in women significantly reduced by short bursts of vigorous activity. December 27, 2024. Accessed April 23, 2025. https://www.contemporaryobgyn.net/view/cardiovascular-risk-in-women-significantly-reduced-by-short-bursts-of-vigorous-activity.
3. VanWiel LL, Carr LJ, Bond DS, et al. Associations of urinary incontinence, physical activity and cardiovascular disease risk among women in the United States. Preventive Medicine. 2025;194. doi:10.1016/j.ypmed.2025.108277