Serum uric acid is an independent risk factor for cardiovascular disease and mortality in hypertensive patients

Objectives: Prehypertension frequently progresses to hypertension and is associated with cardiovascular diseases, stroke, excess morbidity and mortality. However, the identical risk factors for developing hypertension from prehypertension are not clarified. This study is conducted to clarify the risks. Methods: We conducted a retrospective 5-year cohort study using the data from 3,584 prehypertensive Japanese adults (52.1±11.0 years, 2,081 men) in 2004 and reevaluated it 5 years later. We calculated the cumulative incidences of hypertension over 5 years, then, we detected the risk factors and calculated odds ratios (ORs) for developing hypertension by crude analysis and after adjustments for age, sex, body mass index, smoking and drinking habits, baseline systolic and diastolic blood pressure, pulse rate, diabetes mellitus, dyslipidemia, chronic kidney disease, and serum uric acid. We also evaluated whether serum uric acid (hyperuricemia) provided an independent risk for developing hypertension. Results: The cumulative incidence of hypertension from prehypertension over 5 years was 25.3%, but there were no significant differences between women and men (24.4% vs 26.0%, p=0.28). The cumulative incidence of hypertension in subjects with hyperuricemia (n=726) was significantly higher than those without hyperuricemia (n=2,858) (30.7% vs 24.0%, p<0.001). After multivariable adjustments, the risk factors for developing hypertension from prehypertension were age (OR per 1 year increased: 1.023; 95% CI, 1.015-1.032), women (OR versus men: 1.595; 95% CI, 1.269-2.005), higher body mass index (OR per 1 kg/m 2 increased: 1.051; 95% CI 1.021-1.081), higher baseline systolic blood pressure (OR per 1 mmHg increased: 1.072; 95% CI, 1.055-1.089) and diastolic blood pressure (OR per 1 mmHg increased: 1.085; 95% CI, 1.065-1.106), and higher serum uric acid (OR pre 1 mg/dL increased: 1.149; 95% CI, 1.066-1.238), but not smoking and drinking habits, diabetes mellitus, dyslipidemia, and chronic kidney diseases. Conclusions: Increased serum uric acid is an independent risk factor for developing hypertension from prehypertension. Intervention studies are needed to clarify whether the treatments for hyperuricemia in prehypertensive subjects are useful.

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Serum Uric Acid Is Not an Independent Risk Factor for Premature Coronary Artery Disease

Cardiorenal Medicine ◽

10.1159/000355484 ◽

2013 ◽

Vol 3 (4) ◽

pp. 246-253 ◽

Cited By ~ 6

Author(s):

Sara Zand ◽

Akbar Shafiee ◽

Mohammadali Boroumand ◽

Arash Jalali ◽

Younes Nozari

Keyword(s):

Coronary Artery Disease ◽

Uric Acid ◽

Risk Factor ◽

Coronary Artery ◽

Serum Uric Acid ◽

Independent Risk Factor ◽

Premature Coronary Artery Disease ◽

Artery Disease

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Serum Uric Acid: An Independent Risk Factor For Vascular Injury

Methodist DeBakey Cardiovascular Journal ◽

10.14797/mdcj-4-1-14 ◽

2008 ◽

Vol 4 (1) ◽

pp. 14-16

Author(s):

Juan Jorge Olivero ◽

Juan Jose Olivero

Keyword(s):

Uric Acid ◽

Risk Factor ◽

Serum Uric Acid ◽

Vascular Injury ◽

Independent Risk Factor

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Study of prevalence and impact of hyperuricemia in a patient of hypertension

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20170915 ◽

2017 ◽

Vol 4 (2) ◽

pp. 367

Author(s):

Rizwan N. Ansari ◽

Rina V. Gandhi ◽

M. N. Saiyed ◽

Kaushal D. Jain

Keyword(s):

Risk Factors ◽

Uric Acid ◽

Risk Factor ◽

Essential Hypertension ◽

Cardiovascular Risk ◽

Serum Uric Acid ◽

Independent Risk Factor ◽

Biochemical Marker ◽

Direct Relation ◽

Stage 1

Background: The association of raised serum uric acid levels with various cardiovascular risk factors has often led to the debate of whether raised serum uric acid levels could be an independent risk factor in essential hypertension. Hence we carried out a study to examine the possibility of hyperuricemia causing hypertension, to see if there is a relationship between the serum uric acid levels and severity and duration of hypertension.Methods: The study was carried out in Smt. SCL Hospital, Saraspur, Ahmedabad, India, the study period from September 2012 to June 2014, a total of 100 patients were studied. The patients were included if they satisfied the JNC VII criteria for hypertension. They were excluded if they were having any other condition known to cause raised serum uric acid levels and secondary hypertension.Results: With the result based on the study carried out we concluded that there can be a direct relation between hyperuricemia and hypertension. Also the study showed that the SUA levels were significantly increased in patient with stage 2 hypertension in comparasion with those with stage 1 hypertension, showing that the severity of hypertension also related to the SUA levels.Conclusions: Based on the study carried out we concluded that SUA can be used as an early biochemical marker to determine the severity and duration of hypertension.

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Mechanistic Insights of Soluble Uric Acid-related Kidney Disease

Current Medicinal Chemistry ◽

10.2174/0929867326666181211094421 ◽

2020 ◽

Vol 27 (30) ◽

pp. 5056-5066 ◽

Cited By ~ 2

Author(s):

Pan Jing ◽

Min Shi ◽

Liang Ma ◽

Ping Fu

Keyword(s):

Uric Acid ◽

Risk Factor ◽

Kidney Disease ◽

Serum Uric Acid ◽

Independent Risk Factor ◽

Elevated Serum ◽

Tubulointerstitial Fibrosis ◽

Renal Diseases ◽

Glomerular Hypertrophy ◽

Progression Of Kidney Disease

Hyperuricemia, defined as the presence of elevated serum uric acid (sUA), could lead to urate deposit in joints, tendons, kidney and other tissues. Hyperuricemia as an independent risk factor was common in patients during the causation and progression of kidney disease. Uric acid is a soluble final product of endogenous and dietary purine metabolism, which is freely filtered in kidney glomeruli where approximately 90% of filtered uric acid is reabsorbed. Considerable studies have demonstrated that soluble uric acid was involved in the pathophysiology of renal arteriolopathy, tubule injury, tubulointerstitial fibrosis, as well as glomerular hypertrophy and glomerulosclerosis. In the review, we summarized the mechanistic insights of soluble uric acid related renal diseases.

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Uric acid is an independent risk factor for cardiovascular disease? The brisighella heart study

Atherosclerosis Supplements ◽

10.1016/s1567-5688(02)80126-x ◽

2002 ◽

Vol 3 (2) ◽

pp. 91-92

Keyword(s):

Cardiovascular Disease ◽

Uric Acid ◽

Risk Factor ◽

Independent Risk Factor ◽

Heart Study

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P0361THE PREDICTIVE VALUE OF SERUM URIC ACID IN PRIMARY GLOMERULONEPHRITIS PATIENTS: A 5-YEARS RENAL PROGNOSIS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0361 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Mykola Kolesnyk ◽

Natalia Stepanova ◽

Lyudmyla Snisar ◽

Larysa Lebid

Keyword(s):

Uric Acid ◽

Risk Factor ◽

Serum Uric Acid ◽

Independent Risk Factor ◽

Lipid Lowering ◽

Lipid Lowering Therapy ◽

Ckd Progression ◽

Primary Glomerulonephritis ◽

Renal Prognosis

Abstract Background and Aims Primary glomerulonephritis (PGN) is one of the leading causes of end-stage renal disease worldwide. Preservation of renal function is a crucial global goal in the management of patients with chronic kidney disease (CKD) in general and PGN in particular. In addition to classical risk factors, hyperuricemia is regarded to be an independent risk factor for CKD development and progression. However, only a few studies have investigated the impact of hyperuricemia on PGN progression. Therefore, this study aimed to analyze the association between serum uric acid (SUA) concentration and renal prognosis in PGN patients during a 5-year follow-up. Method A total of 344 patients with CKD 1-3 stages were included in this retrospective observational single-center study. Among them, there were 194 (56.4 %) patients with biopsy-proven PGN and 150 (43.6 %) patients with a clinical diagnosis of PGN. All patients were treated according to the KDIGO Practice Clinical Guidelines for Glomerulonephritis. eGFR (milliliters per minute per 1.73 m2) was calculated using the CKD-EPI formula and its baseline value was based on the first available eGFR in PGN diagnosed patients. The patients with eGFR< 30 mL//min/1.73 m2 were excluded from the study at the time of PGN diagnosis. None of the patients was on urate- or lipid-lowering therapy at the time of baseline data. Hyperuricemia was defined as SUA concentration ≥420 μmol/L (7 mg/dL) for males and ≥360 μmol/L (6 mg/dL) for females. The rate of eGFR fall per year was used to assess CKD progression. It was calculated as the difference between eGFR (mL/min/1.73m2) at baseline and the last values: (Last eGFR – Baseline eGFR) / Follow-up period per year). For the analysis, the patients were gender-stratified into 3 SUA quartiles according to average SUA levels at baseline: Q1- < 265 μmol/L for men and <220 μmol/L for women, Q2- 265-446 μmol/L for men and 220-369 μmol/L for women, Q3- ≥ 447 μmol/L for men and ≥ 370 for women. The analysis and all graphs were performed using MedCalc (Belgium). Results Hyperuricemia was found in 72/206 (35 %) men and 38/138 (27.5 %) women (p = 0.0003). During the average 5-years follow-up period (5.3 [3.8-6.2]), there were 114 (33.1%) patients who eventually progressed to eGFR<15 mL/min/1.73 m2 or started RRT. Among them there were: Q1- 10 (12%) patients, Q2 - 52 (31.5%) patients, Q3 - 52 (54.7%) patients (p< 0.0001). The highest renal progression level was observed in Q3 patients: -5.5 [-15.4; -1.8] mL/min/1.73 m2 versus -3.5 [-6.4; -1.7] and -4.6 [-10.6; -2.7] mL/min/1.73 m2 in Q2 and Q1 patients, respectively. In multivariate logistic regression analysis, SUA level in men (≥ 447 μmol/L) and women (≥ 370) was determined as an independent risk factor for rapid CKD progression (OR: 2.5, 95% CI: 1.47-4.23, P = 0.0007). Conclusion. Our study showed that a higher SUA level was associated with a significant rapid eGFR decline during a 5-year follow-up. The study findings suggest that hyperuricemia is a potentially modifiable factor for CKD progression.

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Serum Uric Acid is Associated with Renal Prognosis of Lupus Nephritis in Women but not in Men

Journal of Clinical Medicine ◽

10.3390/jcm9030773 ◽

2020 ◽

Vol 9 (3) ◽

pp. 773 ◽

Cited By ~ 1

Author(s):

Tae Ryom Oh ◽

Hong Sang Choi ◽

Chang Seong Kim ◽

Dong-Ryeol Ryu ◽

Sun-Hee Park ◽

...

Keyword(s):

Uric Acid ◽

Risk Factor ◽

Lupus Nephritis ◽

Serum Uric Acid ◽

Uric Acid Level ◽

Lupus Erythematosus ◽

Acid Level ◽

Independent Risk Factor ◽

Serum Uric Acid Level ◽

Cox Proportional Hazards

Lupus nephritis (LN) is a major complication of systemic lupus erythematosus. Early intervention in lupus nephritis improves prognosis. There is an association between hyperuricemia and lupus nephritis; nevertheless, the sex-specific role of uric acid in lupus nephritis remains unclear. We retrospectively analyzed 578 patients diagnosed with LN by renal biopsy. We determine the relationship of serum uric acid to progression of LN using Kaplan–Meier survival analyses and Cox proportional hazards models. The primary end point was LN progression defined as the initiation of dialysis or kidney transplantation. Men had higher mean serum uric acid levels than did women. Every 1 mg/dL increase in baseline uric acid level increased the risk of LN progression by 15.1%. The serum uric acid level was an independent risk factor for LN progression in women (hazard ratio [HR], 1.158; confidence interval [CI], 1.018–1.317; p = 0.028) but not in men (HR, 1.499; CI, 0.964–2.331; p = 0.072). Sensitivity analysis involving serum uric acid terciles generated consistent and robust results. Serum uric acid level was an independent risk factor for LN progression in women but not in men.

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