Transl Androl Urol. 2026 Feb 28;15(2):44. doi: 10.21037/tau-2025-aw-843. Epub 2026 Feb 11.
ABSTRACT
BACKGROUND: Nocturia is associated with falls, reduced quality of life (QOL), and sleep disturbances, yet remains underdiagnosed and undertreated. Its multifactorial etiology includes reduced bladder capacity, nocturnal polyuria (NP), and comorbid conditions like hypertension. While antihypertensive therapies have been linked to nocturia, the impact of newer agents remains unclear. This study investigated whether sacubitril/valsartan (Sac/Val), a novel angiotensin receptor-neprilysin inhibitor used for refractory hypertension, could improve nocturia. Sac/Val's unique natriuretic and diuretic effects may influence NP through modulation of neurohormonal pathways.
METHODS: Eighteen hypertensive patients with nocturia (mean age 66.7 years) were evaluated over 12 weeks. The primary outcome was change in nighttime voiding frequency, assessed via voiding diaries. Secondary outcomes included Pittsburgh Sleep Quality Index-Japanese Version (PSQI-J), Nocturia Quality of Life Questionnaire (N-QOL), Overactive Bladder Symptom Score (OABSS), International Prostate Symptom Score (IPSS), and overall QOL.
RESULTS: Results showed a significant reduction in nighttime voids (from 3.31 to 2.10) and nocturnal polyuria index (NPi) (from 48.1% to 39.7%). Sleep quality (PSQI-J) and nocturia-related QOL (N-QOL) also improved. No significant changes were observed in IPSS or general QOL scores, while OABSS nocturia scores decreased. This is the first study to demonstrate Sac/Val's potential to improve nocturia, likely via its effects on NP and blood pressure (BP).
CONCLUSIONS: The present study suggests that cardiovascular disease (CVD) may be an often-overlooked factor in the cause of nocturia. Therefore, a multidisciplinary approach is essential for the management of NP, and there is a need to promote collaboration between specialties with an emphasis on developing more patient-specific treatments.
PMID:41809793 | PMC:PMC12968870 | DOI:10.21037/tau-2025-aw-843