A predictive marker for target organ damage in primary hypertension: serum uric acid levels

2021 ◽  
pp. 31-36

Background: This study aims to investigate the relationship between serum uric acid levels, the left ventricular mass index (LVMI), and carotid intima-media thickness (CIMT) in primary hypertension patients. Material and Method: A total of 139 primary hypertension patients, including 45 (32.4%) men and 94 (67.6%) women were involved in the study. The laboratory and clinical demographic findings, as well as the LVMI and CIMT levels of the patients, were collected from patient files. Results: 37% of the study population were found to have hyperuricemia. LVMI (99.75}13.4 vs 86.17±17.6; p=0.010) and CIMT (0.88±0.26 vs 0.75±0.17; p=0.023) levels were found to be higher in the hyperuricemia versus the non-hyperuricemia group. According to the correlation analysis, there was a positive correlation between uric acid and LVMI (r=0.282, p=0.032) and CIMT (r=0.285, p=0.002) levels. Robust regression analysis showed that uric acid was an independent risk factor for both the LVMI (β±SE: 1.615±1.03, p<0.05) and CIMT (β±SE: 0.251±0.09, p<0.05). Conclusion: We found serum uric acid levels to be closely related to the target organ damage associated with primary hypertension, and even related with target organ damage independent from blood pressure.

2020 ◽  
pp. 1-3
Author(s):  
Mahendra Kumar ◽  
Dharmendra Prasad ◽  
Parshuram Yugal ◽  
Debarshi Jana

Background Hypertension is a major risk factor for cardiovascular mortality, as it acts through its effects on target organs, such as the heart and kidneys. Hyperuricemia increases cardiovascular risk in patients with hypertension. Objective To assess the relationship between serum uric acid and target organ damage (left ventricular hypertrophy and microalbuminuria) in untreated patients with essential hypertension. Patients and methods: A cross-sectional study was carried out in 130 (85 females, 45 males) newly diagnosed, untreated patients with essential hypertension. Sixty-five healthy age- and sex-matched non-hypertensive individuals served as controls for comparison. Left ventricular hypertrophy was evaluated by cardiac ultrasound scan, and microalbuminuria was assessed in an early morning midstream urine sample by immunoturbidimetry. Blood samples were collected for assessing uric acid levels. Results Mean serum uric acid was significantly higher among the patients with hypertension (379.7±109.2 μmol/L) than in the controls (296.9±89.8 μmol/L; P<0.001), and the prevalence of hyperuricemia was 46.9% among the hypertensive patients and 16.9% among the controls (P<0.001). Among the hypertensive patients, microalbuminuria was present in 54.1% of those with hyperuricemia and in 24.6% of those with normal uric acid levels (P=0.001). Similarly, left ventricular hypertrophy was more common in the hypertensive patients with hyperuricemia (70.5% versus 42.0%, respectively; P=0.001). There was a significant linear relationship between mean uric acid levels and the number of target organ damage (none versus one versus two: P=0.012). Conclusion These results indicate that serum uric acid is associated with target organ damage in patients with hypertension, even at the time of diagnosis; thus, it is a reliable marker of cardiovascular damage in our patient population.


2005 ◽  
Vol 18 (5) ◽  
pp. A1-A1
Author(s):  
F VIAZZI ◽  
G LEONCINI ◽  
E RATTO ◽  
V VACCARO ◽  
A PARODI ◽  
...  

Hypertension ◽  
2005 ◽  
Vol 45 (5) ◽  
pp. 991-996 ◽  
Author(s):  
Francesca Viazzi ◽  
Denise Parodi ◽  
Giovanna Leoncini ◽  
Angelica Parodi ◽  
Valeria Falqui ◽  
...  

2005 ◽  
Vol 19 (3) ◽  
pp. 211-217 ◽  
Author(s):  
C Tsioufis ◽  
D Chatzis ◽  
E Vezali ◽  
K Dimitriadis ◽  
D Antoniadis ◽  
...  

2004 ◽  
Vol 22 (Suppl. 2) ◽  
pp. S236-S237
Author(s):  
E. Vezali ◽  
C. Tsioufis ◽  
E. Taxiarchou ◽  
K. Dimitriadis ◽  
L. Naoumidou ◽  
...  

1970 ◽  
Vol 32 (3) ◽  
pp. 30-33
Author(s):  
SK Das ◽  
SC Jha

Introduction: Despite the widely recognized dangers of uncontrolled hypertension, the disease remains inadequately treated in the majority of patients. This may be, in large part, because of the asymptomatic nature of the disease for the first 15 to 20 years, even as it progressively damages the cardiovascular system. Therefore, assessment of hypertension related subclinical target-organ damage represents a key diagnostic procedure for the risk stratification of hypertensive patients. Methods: A prospective case control study of 40 cases (hypertensive patients with CCR<60) and 40 controls (hypertensive patients with CCR>60) was conducted in Tribhuvan University Teaching Hospital (TUTH). Renal function was estimated by the Cockcroft-Gault formula. Left ventricular hypertrophy was determined by echocardiography. Retinal vascular changes were evaluated by direct ophthalmoscopy. Microalbumin in urine was measured from spot morning sample. Results: The prevalence of Left ventricular hypertrophy (LVH), microalbuminuria and retinopathy in cases and control group was 55% VS 20% (P=.001), 50% VS 20% (P=.004) and 92.5% VS 52.5% (P=.001). Patients with microalbuminuria showed prevalence of LVH, CCR<60 and retinopathy as 78.57%, 71.43% and 100% respectively. There was high prevalence of grade I and grade II retinopathy in patients with low CCR Conclusions: Results show that a reduction in creatinine clearance and/or presence of microalbuminuria is a marker of subclinical organ damage in patients with primary hypertension and normal serum creatinine irrespective of BP load and other traditional risk factors. Keywords: Creatinine clearance; primary hypertension; subclinical; target organ damage. DOI: http://dx.doi.org/10.3126/joim.v32i3.4957 Journal of Institute of Medicine, December, 2010; 32:3 30-33


Author(s):  
Anping Cai ◽  
Lin Liu ◽  
Mohammed Siddiqui ◽  
Dan Zhou ◽  
Jiyan Chen ◽  
...  

Abstract BACKGROUND Hypertensive patients with increased serum uric acid (SUA) are at increased cardiovascular (CV) risks. Both the European and American hypertension guidelines endorse the utilization of 24 h-ambulatory blood pressure monitoring (24 h-ABPM) for hypertensive patients with increased CV risk. While there is difference in identifying uric acid as a CV risk factor between the European and American guidelines. Therefore, it is unknown whether 24 h-ABPM should be used routinely in hypertensive patients with increased SUA. METHODS To address this knowledge gap, we investigated (i) the correlation between SUA and 24 h-ABP; (ii) the association between SUA and blood pressure (BP) phenotypes (controlled hypertension [CH], white-coat uncontrolled hypertension [WCUH], masked uncontrolled hypertension [MUCH], and sustained uncontrolled hypertension [SUCH]); (iii) the association between SUA and target organ damage (TOD: microalbuminuria, left ventricular hypertrophy [LVH], and arterial stiffness) according to BP phenotypes. RESULTS In 1,336 treated hypertensive patients (mean age 61.2 and female 55.4%), we found (i) there was no correlation between SUA and 24 h, daytime, and nighttime systolic blood pressure/diastolic blood pressure, respectively; (ii) in reference to CH, SUA increase was not associated WCUH (odds ratio [OR] 0.968, P = 0.609), MUCH (OR 1.026, P = 0.545), and SUCH (OR 1.003, P = 0.943); (iii) the overall prevalence of microalbuminuria, LVH, and arterial stiffness was 2.3%, 16.7%, and 23.2%, respectively. After adjustment for covariates, including age, sex, smoking, body mass index, diabetes mellitus, and estimated glomerular filtration rate, there was no association between SUA and TOD in all BP phenotypes. CONCLUSIONS These preliminary findings did not support routine use of 24 h-ABPM in treated hypertensive patients with increased SUA.


2020 ◽  
Vol 33 (9) ◽  
pp. 869-878 ◽  
Author(s):  
Mehmet Kanbay ◽  
Nicolas Girerd ◽  
Jean-Loup Machu ◽  
Erwan Bozec ◽  
Kevin Duarte ◽  
...  

Abstract BACKGROUND Recent studies have shown that hyperuricemia may be associated with incident hypertension (HTN). We examined whether serum uric acid (SUA) is a predictor of HTN and target organ damage (TOD) 20 years later in initially healthy middle-aged individuals. METHODS Participants from the Suivi Temporaire Annuel Non-Invasif de la Santé des Lorrains Assurés Sociaux (STANISLAS) a single-center familial longitudinal cohort study (961 initially healthy adults and 570 children) underwent clinical and laboratory measurements at baseline and after approximately 20 years. Blood pressure (BP: using ambulatory BP measurements), urine albumin-to-creatinine ratio, estimated glomerular filtration rate (eGFR), left ventricular hypertrophy (LVH), diastolic dysfunction, and carotid–femoral pulse wave velocity (PWV) were measured at the end of follow-up. RESULTS In the parent population, higher baseline or last SUA levels and higher change in SUA (ΔUA) were significantly associated with an increased risk of HTN development, even after adjusting for known HTN risk factors (all P &lt; 0.01). Higher baseline SUA was marginally associated with an increased risk of having high carotid–femoral PWV (P = 0.05). The association of SUA with BP increase was body mass index dependent (the increase in BP being greater in leaner subjects; interactionp &lt; 0.05), and the association of SUA with eGFR decline was age dependent (the decline in eGFR being greater in older subjects; interactionp &lt; 0.05). There was no significant association between SUA and diastolic dysfunction or LVH. In the whole population (i.e. including children), a significant association between SUA at baseline and the risk of HTN and higher carotid–femoral PWV was also found (both P &lt; 0.02). CONCLUSIONS Increased SUA is associated with the development of HTN and vascular/renal TOD in initially healthy midlife subjects.


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