Abstract 3488: Hyperuricemia and the Risk of Isolated Hypertension among Young People without Cardiovascular and Metabolic Risk Factors: The CARDIA Study

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Eswar Krishnan ◽  
Hyon K Choi ◽  
Lewis H Kuller ◽  
Kiang Liu
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Uric Acid ◽  
Cardiovascular Risk ◽  
Young People ◽  
Cardiovascular Risk Factors ◽  
Serum Uric Acid ◽  
The Metabolic Syndrome

PURPOSE: The association between higher serum uric acid (SUA) levels and hypertension in the context of the metabolic syndrome is well known. If such an association was causal, one would expect to demonstrate a link between hyperuricemia and incidence of isolated hypertension - a hypothesis that has not been tested so far. METHODS: We used the 15-year limited-access data from the prospective cohort study of Coronary Artery Risk Development in young adults (CARDIA), sponsored by the National Institutes of Health, to identify a group of non-smoking young people with normal blood pressure and free of insulin resistance, hyperlipidemia, obesity, and a family history of cardiovascular diseases. These young people aged between 18 and 30 years at baseline were followed-up for a period of 15 years by 6 study visits where all cardiovascular risk factors were reassessed. Incidence of JNC-7 hypertension was the outcome of interest in Cox proportional hazards models where age, gender, race, lipid levels, blood pressure, alcohol, body mass index, smoking and serum insulin levels (time-varying where appropriate) were the covariates. Baseline serum uric acid (continuous) was the independent variable of interest. A second set of Cox regression analyses was performed among the subgroup of these individuals who remained free of all cardiovascular risk factors (except for hypertension) over the 15-year follow up. RESULTS: Out of the 5113 CARDIA participants at baseline, 2057 subjects were free of cardiovascular risk factors at baseline and were available for evaluation at year 15. Over the follow-up period, 828 subjects developed hypertension. In multivariate Cox models, each mg/dl increase in serum uric acid was associated with a hazard ratio of 1.45 (1.09–1.91). In the second set of analyses, 753 were free of all cardiovascular risk factors at baseline and remained free of any of the components of the metabolic syndrome except hypertension (n = 122 incident cases of hypertension) were studied. In these analyses each mg/dl increasse in SUA was associated with a risk adjusted hazard ratio of 1.60 (95% CI 1.02–2.49). CONCLUSIONS: Unrelated to the other features of the metabolic syndrome, higher levels of SUA among young people predicts isolated hypertension.

scholarly journals Is the increase of uric acid associated with the components of the metabolic syndrome?

2020 ◽  
Vol 26 (1) ◽  
pp. 7-13
Author(s):  
Vaida Sudmantaitė ◽  
Jurgita Mikolaitytė ◽  
Jolita Badarienė ◽  
Alma Čypienė ◽  
Agnė Jucevičienė ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Uric Acid ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Serum Uric Acid ◽  
Serum Uric Acid Level ◽  
Density Lipoprotein ◽  
Cross Sectional ◽  
The Metabolic Syndrome

Summary Objectives: There is increasing evidence that metabolic syndrome (MetS) may be associated with increased uric acid levels. Previous studies indicate that hyperuricaemia is an independent risk factor for cardiovascular disorders. We sought to determine the association of serum uric acid (SUA) with MetS components and other cardiovascular risk factors among middle aged Lithuanians with MetS. Design and methods: A cross-sectional study was conducted in 2018. A total of 705 subjects aged 40 to 65 years with MetS diagnosed using NCEP ATP III criteria were included. None of the participants had previously diagnosed cardiovascular, cerebrovascular, peripheral artery or end-stage oncological disease. Blood tests and all anthropometric measurements were obtained using standard methods. Subjects were divided into 2 groups: with hyperuricaemia and without hyperuricaemia. Results: Hyperuricaemia was found in 33.3% of subjects. Mean serum uric acid level increased as the number of metabolic factors increased. Participants with hyperuricaemia had abnormal waist circumference (p < 0.001), higher systolic (p = 0.001) and diastolic blood pressure (p = 0.003), higher levels of triglycerides and, lower levels of high-density lipoprotein cholesterol (p < 0.001). Subjects in hyperuricaemia group were more likely to be alcohol users (p = 0.034), to have diabetes (p = 0.02) and higher body mass index (p < 0.001). Their creatinine levels were statistically significantly higher (p < 0.001). Conclusions: Our analysis showed that serum uric acid is associated with MetS and other cardiovascular risk factors. The study found a statistically significant association with the four out of five components of the MetS (excluding plasma glucose) as well as with alcohol consumption, and renal function indicators (creatinine, eGFR).

Serum Uric Acid, Lipid Profile and Atherogenic Index of Plasma in Dipper and Non-dipper Normotensive Subjects

2021 ◽  
Author(s):  
Wai Wai Phyo Nwe ◽  
Aye Mya Mya Thwin ◽  
Myat San Yi ◽  
Khin Than Yee ◽  
San Thitsa Aung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Uric Acid ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Serum Uric Acid ◽  
Interquartile Range ◽  
Atherogenic Index ◽  
Atherogenic Index Of Plasma ◽  
Normotensive Subjects

The cardiovascular risk evidentially found to have an association with disparities of the dipper and non-dipper hypertension. There is less celerity with regard to mechanism of diurnal blood pressure variations and related disorders. The serum uric acid and AIP are considered as cardiovascular risk factors. The current study aims to determine and compare serum uric acid level and atherogenic index of plasma (AIP) in dipper and non-dipper normotensive subjects. The study population is 64 healthy normotensive subjects (32 dippers and 32 non-dippers), age between 30-55 years. The subjects were identified into dippers and non-dippers by using ambulatory blood pressure monitoring device (Spacelabs 90207, USA). After identifying dipping status of the subjects, uric acid, triglycerides and HDL cholesterol were measured. AIP was calculated by using formula (log [TG/HDL]). Median (interquartile range) of serum uric acid in the dipper group was 5.08mg/dl (4.12-5.66) and the non-dipper group was 5.27mg/dl (4.63-6.33). The median (interquartile range) for AIP was 0.24 (0.05-0.38) in the dipper group and 0.48 (0.32-0.67) in the non-dipper group. The median (interquartile range) of uric acid and AIP in the non-dipper group was significantly higher than that of dipper group (p<0.05). This study observed in even normotensive subjects, the non-dipper group has significantly higher serum uric acid and AIP than that of dipper group. These cardiovascular risk factors increased in non-dipper group compared to dipper group. The study come out with concluded that non-dipper group had higher cardiovascular risk than dipper group even in normotensive healthy subjects.

Investigation of the prevalence of cardiovascular risk factors in obese patients diagnosed with metabolic syndrome in childhood and examination of left ventricular function by echocardiography

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Güzin Özden ◽  
Ayşe Esin Kibar Gül ◽  
Eda Mengen ◽  
Ahmet Ucaktürk ◽  
Hazım Alper Gürsu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Left Ventricular ◽  
Atherogenic Index ◽  
Volume Index ◽  
Common Component

Abstract Objectives The objective of this study is to investigate the cardiovascular risk factors associated with metabolic syndrome (MetS), which is increasingly becoming prevalent in childhood obesity. Methods A total of 113 patients, 76 of whom were between the ages of 10 and 17 (mean age: 14.5 ± 1.8 years) and diagnosed with obesity (30 non-MetS and 46 MetS using IDF) and 37 of whom constituted the control group, participated in the study. Echocardiographic examination and atherogenicity parameters (Atherogenic index of plasma [AIP: logTG/HDL], total cholesterol/HDL, and TG/HDL ratio and non-HDL) were evaluated. Results The most common component accompanying obese MetS was found to be hypertension and low HDL. While obesity duration, body mass index (BMI), blood pressure, fasting insulin, insulin resistance, atherogenicity parameters were determined to be significantly higher in the obese-MetS group. Echocardiography showed that while the thickness, volume, and diameter of LV end-diastolic wall, left ventricular mass (LVM), LVM index (LVMI g/m2) and relative wall thickness (RWT) were significantly high in the MetS group, however, mitral E/A ratio was significantly lower (p<0.05). Change in LV geometry consistent with concentric remodeling (increased RWT, normal LVMI) was visible in obese groups. LVM were positively significantly related to BMI, waist circumference, insulin resistance, blood pressure, LDL level, and negative to mitral E/A ratio. In the obese-MetS group, LVMI was positively correlated to office systolic BP, left atrium end-diastolic volume/index. Conclusions LVMI and atherogenicity parameters that were found to be significantly higher in obese MetS exhibit increased cardiovascular risk in childhood.

AB1207 EFFECT ON DIET MODIFICATION ON GOUT AND METABOLIC SYNDROME RISK FACTORS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1895.1-1895
Author(s):  
J. Chang ◽  
J. Tsui ◽  
M. Wong
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Hemoglobin A1c ◽  
Long Beach ◽  
Dietary Counseling ◽  
The Metabolic Syndrome ◽  
Diet Counseling ◽  
Ed Visits

Background:Gout is the most prevalent inflammatory arthritis globally. Despite treatment advances, the prevalence of gout has continued to increase over the last several decades. There has also been increasing evidence that gout has a strong association with the metabolic syndrome. This indicates that gout is likely both an inflammatory and a metabolic disease that has a significant effect on quality of life and healthcare costs. Although current recommendations support aggressive medical therapy for gout treatment, dietary counseling is less emphasized. We hypothesize that emphasis on this nonpharmacological therapy will likely improve management and the metabolic syndrome in gout patients.Objectives:To analyze the effectiveness of dietary counseling on gout management and risk factors for metabolic syndrome in gout patients at the Veteran’s Affairs Medical Center in Long Beach, CA (VALB).Methods:A retrospective cohort study was created from 2009-2016 involving Long Beach Veterans Affairs Hospital gout patients (n= 119) based on International Classification of Disease version 9 or 10. Patients were then stratified into two cohorts: received diet counseling (n=90) and no diet counseling (n=29). Data was reviewed for 24 months following initial gout diagnosis or intervention. Management was evaluated based on frequency of flares and related ED visits, change in creatinine clearance, serum uric acid levels (sUA), and changes to risk factors for metabolic syndrome including blood pressure, body mass index (BMI), cholesterol panel and hemoglobin A1c levels at six-month intervals.Results:Although patients in both cohorts were noted to have decreased number of gout attacks, patients who received diet counseling had a significant decrease in number of gout attacks by month 12 (0=0.004). In addition, after 6 months, patients who received diet counseling were more likely to have sUA at goal (sUA<6 for nontophaeous gout and sUA<5 for tophaceous gout) (p=0.003). These patients were also noted to have improved creatinine clearance (p=0.08) and increased HDL (p =0.08). In addition, patients with improved HDL and LDL values more likely to have improved sUA levels and decreased ED visits (R2=0.4, slope 0.14 and R2=0.4, slope 0.05, respectively) by month 6. Patients with improved hemoglobin A1c levels were also noted to have a significant outcome in lowering serum uric acid level at month 18 (R2=0.9, slope 2.6).Conclusion:Gout patients who receive diet counseling had lower rate of future attacks and better control of sUA. In addition, these gout patients were also noted to have improvement in some risk factors associated with the metabolic syndrome. Notably, patients who had better control of their hemoglobin A1c levels were able to have lower serum uric acid levels. This may imply that controlling diabetes in patients may also help improve gout management. Given the serious complications and increased cardiovascular risks that can be associated with metabolic syndrome, optimization of gout through a nonpharmacologic intervention such as diet counseling can enhance clinical outcomes and optimize healthcare resources.References:[1]Rai SK et al. The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study. BMJ. 2017;357:j1794.[2]Álvarez-lario B, et al. Hyperuricemia and gout; the role of diet. Nutr Hosp. 2014;29(4):760-70.Disclosure of Interests:None declared

Uric acid and uric acid/creatinine ratio and their correlations with the hemorheological determinants in subjects with subclinical carotid atherosclerosis

2022 ◽  
pp. 1-9
Author(s):  
Gregorio Caimi ◽  
Caterina Urso ◽  
Salvatore Brucculeri ◽  
Corrado Amato ◽  
Rosalia Lo Presti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Uric Acid ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Serum Uric Acid ◽  
Carotid Atherosclerosis ◽  
Erythrocyte Aggregation ◽  
Creatinine Ratio ◽  
Serum Uric Acid Concentration

BACKGROUND AND OBJECTIVE: we have examined the concentration of serum uric acid and the serum uric acid/creatinine ratio as well as their correlations with the main determinants of the hemorheological profile in a group of subjects with subclinical carotid atherosclerosis. METHODS: we evaluated the concentration of serum uric acid and the serum uric acid/creatine ratio in 43 men and 57 women [median age 66.00 (25)] with subclinical carotid atherosclerosis, subsequently divided according to the number of traditional cardiovascular risk factors and to the insulin resistance degree. RESULTS: serum uric acid, but not the serum uric acid/creatinine ratio, results strongly influenced by the number of cardiovascular risk factors and by the insulin resistance degree. In the whole group and in the subgroups of subclinical carotid atherosclerosis subjects, serum uric acid and serum uric acid/creatinine ratio show significant correlation, besides with whole blood viscosity, with plasma viscosity and erythrocyte aggregation. The influence of the serum uric acid on the erythrocyte aggregability that is a part of the erythrocyte aggregation is to ascribe to the action carried out by serum uric acid on the erythrocyte zeta potential. CONCLUSIONS: it is reasonable to think that the treatment of the asymptomatic or symptomatic hyperuricemia with the urate-lowering therapy that reduces the serum uric acid concentration may reflect on the hemorheological profile which role on the atherosclerotic cardiovascular disease is well known.

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