1
|
Sheng S, Chen J, Zhang Y, Li W, Li F, Gou R, Tang L, Ding S. A Cohort Study on the Correlation Between Serum Uric Acid Trajectory and New-Onset Hypertension Based on Longitudinal Health Examination Data in Henan Area. J Inflamm Res 2024; 17:1365-1375. [PMID: 38439928 PMCID: PMC10909652 DOI: 10.2147/jir.s446342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/16/2024] [Indexed: 03/06/2024] Open
Abstract
Objective To explore the correlation between serum uric acid (SUA) trajectories and new-onset hypertension, to provide scientific basis for the prevention and treatment of hypertension. Methods The study cohort was composed of 4372 subjects who met the inclusion criteria in the cohort study of Henan physical examination population. According to the SUA values of the subjects' physical examination from 2017 to 2019, three different SUA trajectory groups were determined by R LCTM tools, namely low stability group, medium stability group and high stability group. The incidence of hypertension during physical examination in 2020 was followed up, the cumulative incidence rate in each group was calculated by product limit method, and the correlation between different SUA trajectories and new-onset hypertension was analyzed by Cox proportional hazards regression model. Results The incidence rate of hypertension increased with the increase of SUA locus, which was 4.65%, 9.18% and 12.43% respectively, and the difference was statistically significant (P<0.001). After adjusting multiple confounding factors, such as gender, waist circumference (WC), blood pressure, body mass index (BMI), fasting plasma glucose (FPG) and blood lipid by Cox proportional hazards regression model, the risk of hypertension in SUA medium stability and high stability group was still 1.476 times (95% CI: 1.089~2.000) and 1.692 times (95% CI: 1.152~2.484) of low-stable SUA group (P<0.05). Conclusion The risk of hypertension increases with the increase of SUA level in the long-term normal range. It is necessary to carry out the intervention for hypertension with long-term normal high value to avoid the progress of hypertension disease, to achieve the purpose of early prevention of hypertension.
Collapse
Affiliation(s)
- Shifeng Sheng
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Jingfeng Chen
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Yuheng Zhang
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Weikang Li
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Feifei Li
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Rong Gou
- Department of Nephropathy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Lin Tang
- Department of Nephropathy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Suying Ding
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| |
Collapse
|
2
|
Ubhadiya TJ, Dubey N, Sojitra MH, Shah K, Joshi S, Gandhi SK, Patel P. Exploring the Effects of Elevated Serum Uric Acid Levels on Hypertension: A Scoping Review of Hyperuricemia. Cureus 2023; 15:e43361. [PMID: 37701002 PMCID: PMC10494276 DOI: 10.7759/cureus.43361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2023] [Indexed: 09/14/2023] Open
Abstract
Hypertension (HTN) is a global health concern due to its increasing prevalence and association with life-threatening complications. An intriguing area of investigation in HTN research is the relationship between HTN and hyperuricemia. In light of this, we conducted a review to summarize the relevant studies exploring the link between elevated serum uric acid (sUA) concentration and new-onset HTN. Through a comprehensive search of PubMed Central, MEDLINE, and PubMed databases, we identified 20 studies that met our inclusion criteria. The research encompassed various study designs, including cohort studies, cross-sectional studies, reviews, and clinical trials. Pathologically, the elevated sUA levels activate the renin-angiotensin system and also cause the formation of urate crystals, triggering inflammation in the kidneys. Additionally, direct effects on the endothelium contribute to inflammation, oxidative stress, nitric oxide depletion, and smooth muscle cell proliferation, ultimately leading to atherosclerosis. These diverse mechanisms collectively play a role in the pathogenesis of HTN. Interestingly, lowering sUA has been shown to reverse early-stage HTN dependent on uric acid. However, this effect is not observed in the uric acid-independent second stage of HTN. Various studies have demonstrated an independent and dose-dependent association between sUA levels and the prevalence of HTN across different populations and genders. The review highlights the potential role of uric acid-lowering drugs, like allopurinol, in the prevention and early-stage management of HTN. However, there is scarce research on the efficacy of other uric acid-lowering agents and combination therapies. We believe our review provides compelling evidence of the association between elevated sUA concentration and new-onset HTN. Identifying and managing hyperuricemia can provide a preventive approach to reducing the burden of HTN and its associated complications.
Collapse
Affiliation(s)
- Tyagi J Ubhadiya
- Department of Internal Medicine, Civil Hospital Ahmedabad, Ahmedabad, IND
| | - Nidhi Dubey
- Department of Internal Medicine, Civil Hospital Ahmedabad, Ahmedabad, IND
| | - Mihir H Sojitra
- Department of Neurology, Civil Hospital Ahmedabad, Ahmedabad, IND
| | - Karan Shah
- Department of Internal Medicine, Civil Hospital Ahmedabad, Ahmedabad, IND
| | - Saumya Joshi
- Department of Internal Medicine, Civil Hospital Ahmedabad, Ahmedabad, IND
| | | | - Priyansh Patel
- Department of Internal Medicine, Medical College Baroda, Vadodara, IND
| |
Collapse
|
3
|
Tian X, Chen S, Wang P, Xu Q, Zhang Y, Zhang X, Wu S, Luo Y, Wang A. Temporal relationship between hyperuricemia and hypertension and its impact on future risk of cardiovascular disease. Eur J Intern Med 2023; 111:82-89. [PMID: 36890009 DOI: 10.1016/j.ejim.2023.02.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/21/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Although hyperuricemia and hypertension are significantly correlated, their temporal relationship and whether this relationship is associated with risk of cardiovascular disease (CVD) are largely unknown. This study aimed to examine temporal relationship between hyperuricemia and hypertension, and its association with future risk of CVD. METHODS This study included 60,285 participants from the Kailuan study. Measurement of serum uric acid (SUA), systolic and diastolic blood pressure (SBP and DBP) were obtained twice at 2006 (baseline) and 2010. Cross-lagged and mediation analysis were used to examine the temporal relationship between hyperuricemia and hypertension, and the association of this temporal relationship with CVD events risk after 2010. RESULTS After adjusting for covariates, the cross-lagged path coefficients (β1) from baseline SUA to follow-up SBP and DBP were significantly greatly than path coefficients (β2) from baseline SBP and DBP to follow-up SUA (β1=0.041 versus β2=0.003; Pdifference<0.0001 for SBP; β1=0.040 versus β2=0.000; Pdifference<0.0001 for DBP). The path coefficients from baseline SUA to follow-up SBP and DBP in group with incident CVD were significantly greatly than that in group without incident CVD (Pdifference of β1 in the two groups was 0.0018 for SBP and 0.0340 for DBP). Furthermore, SBP and DBP partially mediated the effect of SUA on incident CVD, the mediation effect was 57.64% for SBP and 46.27% for DBP. Similar mediated results were observed for stroke and myocardial infarction. CONCLUSION Increased SUA levels probably precede elevated BP, and BP partially mediates the pathway from SUA to incident CVD.
Collapse
Affiliation(s)
- Xue Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Penglian Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qin Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yijun Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xiaoli Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| |
Collapse
|
4
|
Association between Serum Uric Acid and Hypertension in a Large Cross-Section Study in a Chinese Population. J Cardiovasc Dev Dis 2022; 9:jcdd9100346. [PMID: 36286298 PMCID: PMC9604751 DOI: 10.3390/jcdd9100346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/19/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
Background: The association of serum uric acid (SUA) with hypertension has been well established in Caucasian populations. However, its association with hypertension in Chinese remained to be clarified. Methods: Consecutive patients, homogeneous in Chinese Han ethnicity, aged ≥18 years, abstracted from the database, admitted from 1 January 2010 to 31 December 2013, were included for potential analysis. The patients were grouped according to the presence or absence of hypertension. Unconditional logistic regression was performed to estimate the association between SUA and hypertension. Its possible interactions with risk factors on hypertension were also explored. Results: A total of 9587 patients were finally analyzed in the current study, where 5692 were with hypertension and 3895 were without hypertension. Per 100 μmol/L higher SUA concentration was associated with multivariable-adjusted odds ratios (95% CI) of 1.25 (1.08−1.22) in males, 1.10 (1.01−1.20) in females, and 1.19 (1.13−1.24) in total. On a categorical scale, when compared with the first quintile, the multivariable-adjusted odds ratios (95% CI) were 1.40 (1.20−1.64) for the 2nd quintile, 1.48 (1.27−1.74) for the 3rd quintile, 1.55 (1.32−1.82) for the 4th quintile, and 1.92 (1.63−2.26) for the 5th quintile, with a p for trend < 0.01. Conclusions: SUA is associated with hypertension in a dose-response manner among the Chinese hospitalized population. Management of SUA could help to the prevention and control of hypertension.
Collapse
|
5
|
Long T, Liu L. Research Progress on the Relationship between Dietary Patterns and Hyperuricemia. Appl Bionics Biomech 2022; 2022:5658423. [PMID: 36164548 PMCID: PMC9509246 DOI: 10.1155/2022/5658423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 11/18/2022] Open
Abstract
As the final metabolite of purine metabolism, uric acid is critically associated with human health. The serum uric acid level is regulated by diet and the metabolic capacity of the human body. The impaired control of uric acid metabolism and excretion is associated with the increased level of serum uric acid, which ultimately results in hyperuricemia. Hyperuricemia is the "fourth-highest" after hypertension, hyperglycemia, and hyperlipidemia. With progress made in the relationship between diet and hyperuricemia, different dietary patterns and lifestyles have been discussed, such as exercise, the amount intake of meat, seafood, supplements with omega-3 fatty acids, sugar-sweetened soft drinks and energy drinks, and lower-fat-containing foods as well as drinking beer, wine, and spirits in the present article. This study demonstrated that a lower risk of hyperuricemia is substantially correlated with higher baseline adherence to MeDiet, and plant polyphenols can combat hyperuricemia by blocking xanthine oxidase.
Collapse
Affiliation(s)
- Tian Long
- Department of Clinical Nutrition, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, Huangshi, Hubei 435000, China
| | - Liang Liu
- Department of Clinical Nutrition, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, Huangshi, Hubei 435000, China
| |
Collapse
|
6
|
Kim IJ, Kim W, Go TH, Kang DR, Kim JY, Kim EJ. Validation of age- and sex-dependent association of uric acid and incident hypertension in rural areas. Clin Hypertens 2022; 28:24. [PMID: 36045451 PMCID: PMC9434906 DOI: 10.1186/s40885-022-00206-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 04/10/2022] [Indexed: 12/05/2022] Open
Abstract
Background A previous study based on urban areas suggested the age- and sex-dependent association of uric acid (UA) and incident hypertension. We aimed to investigate whether this association is valid even in rural areas with different lifestyle. Methods Data from the cardiovascular disease association study, a prospective cohort study based on rural residents, was analyzed. A total of 4,592 subjects (mean age, 60.1 ± 9.5 years; men, 37.7%) without hypertension were included. We first investigated whether UA was a risk factor for incident hypertension using Cox regression, and then compared the relative risk by stratification according to age and sex. Results During the follow-up period (mean, 2.0 years), 579 subjects (12.6%) were newly diagnosed with hypertension. The risk factors for incident hypertension were age (Hazard ratios [HR] for ≥ 65, 1.26), systolic blood pressure (HR per 1 mmHg increase, 1.07), and serum UA concentration (HR per 1 mmHg increase, 1.10). The risk of UA-related incident hypertension was higher in the non-elderly than in the elderly for both men and women (HR, 1.74 for non-elderly men; 1.88 for non-elderly women; 1.66 for elderly men; 1.10 for elderly women). Even after adjusting for multiple confounders, the risk of UA-related incident hypertension was significantly higher in non-elderly women (HR, 1.59; P < 0.05). Conclusions Age- and sex-dependent association of UA with incident hypertension suggested in cohort study based on urban areas was consistently found in rural areas as well. In particular, non-elderly women were at a higher risk for UA-related incident hypertension. Supplementary information The online version contains supplementary material available at 10.1186/s40885-022-00206-5.
Collapse
Affiliation(s)
- In Jae Kim
- Department of Cardiology, Namwon Medical Center, Namwon, Republic of Korea
| | - Woohyeun Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, 222-1, Wangsimni-ro, Seongdong-gu, 04763, Seoul, Republic of Korea.
| | - Tae Hwa Go
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Dae Ryong Kang
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jang-Young Kim
- Department of Cardiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Eung Ju Kim
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea
| |
Collapse
|
7
|
Mediating effects of insulin resistance on the development of hypertension associated with elevated serum uric acid: a prospective cohort study. J Hum Hypertens 2022; 36:760-766. [PMID: 34148058 DOI: 10.1038/s41371-021-00562-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 05/28/2021] [Accepted: 06/07/2021] [Indexed: 11/08/2022]
Abstract
Many studies have demonstrated that elevated serum uric acid independently increases the risk of developing hypertension. However, the role of insulin resistance in the relationship between serum uric acid and hypertension is still unelucidated. Based on a prospective cohort study, we aimed to examine the longitudinal link between serum uric acid and hypertension and whether this relationship was mediated by insulin resistance. Overall, 21,999 participants without hypertension or gout at baseline with a mean age of 46 ± 13 years in the Jinchang Cohort were included in our study. Adjusted Cox-regression analyses and mediation analyses were performed to assess the risk of hypertension by serum uric acid quartile distribution and whether insulin resistance mediated the association between serum uric acid and hypertension. During the first follow-up period, 3080 participants developed hypertension. After controlling for covariates, compared with the lowest quartile of serum uric acid, the risk of hypertension in the highest quartile was 1.21 (1.06, 1.38) in the overall population. The risks for males and females were 1.14 (1.00-1.29) and 1.30 (1.08-1.56), respectively. The correlation between serum uric acid and hypertension was especially observed in younger people (<30 years). The mediating effects of insulin resistance were 0.058 (0.051, 0.065), 0.030 (0.025, 0.036) and 0.056 (0.047, 0.065), and the proportions mediated were 39.73, 36.59 and 38.62% in the overall, male and female populations, respectively. Elevated serum uric acid levels are associated with an increased risk of incident hypertension, and insulin resistance may play a mediating role in the relationship between serum uric acid and hypertension.
Collapse
|
8
|
Han Y, Han K, Han X, Yin Y, Di H, Wu J, Zhang Y, Zeng X. Serum Uric Acid Might Be Positively Associated With Hypertension in Chinese Adults: An Analysis of the China Health and Nutrition Survey. Front Med (Lausanne) 2022; 8:755509. [PMID: 35071258 PMCID: PMC8766717 DOI: 10.3389/fmed.2021.755509] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/06/2021] [Indexed: 12/22/2022] Open
Abstract
Background: Previous studies have clarified the relationship between serum uric acid (SUA) and hypertension; most of previous studies suggest that elevated uric acid levels are associated with an increased risk of hypertension, while in China, there are relatively few studies to explore above association. The objective of this longitudinal study is to investigate the correlation of SUA and hypertension in Chinese adults with a nationwide large-scale sample. Methods: Data from the China Health and Nutrition Survey 2009, 2011, and 2016 were used; a total of 8,469 participants (3,973 men and 4,496 women) were involved. This study was conducted separately by gender. Clinical characteristics of the participants among different uric acid groups are compared. The binary logistic regression analysis was conducted to examine the association between SUA and hypertension. Restricted cubic spline analysis with three knots of the SUA concentration were used to characterize the dose-response relationship. Additionally, we compared the incidence of hypertension in the different baseline uric acid groups during follow-up in 2011 and 2015. Results: After the covariates were fully adjusted, we found that elevated uric acid levels were correlated with increased risk of hypertension in both males (p < 0.01) and females (p < 0.01). With 2-year or 6-year of follow-up, we found participants with higher baseline uric acid levels had a higher incidence of hypertension (p < 0.01). In stratified analysis by obesity, above relationship remained significant in nonobesity population (males: p < 0.05, females: p < 0.01) and became nonsignificant in obesity people. In stratified analysis by age, above positively correlation remained significant in middle-aged men (p < 0.05) and elderly women (p < 0.01). Restricted cubic spline revealed the dose-response relationship between SUA and hypertension; we also found that above relationship was much stronger in females. Conclusion: This study suggests that elevated SUA levels might be positively associated with an increased risk of hypertension in general Chinese adults.
Collapse
Affiliation(s)
- Yingdong Han
- Division of General Internal Medicine, Department of Primary Care and Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Kaidi Han
- Department of Critical Care Medicine, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Xinxin Han
- Division of General Internal Medicine, Department of Primary Care and Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yue Yin
- Division of General Internal Medicine, Department of Primary Care and Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Hong Di
- Division of General Internal Medicine, Department of Primary Care and Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Juan Wu
- Division of General Internal Medicine, Department of Primary Care and Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yun Zhang
- Division of General Internal Medicine, Department of Primary Care and Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xuejun Zeng
- Division of General Internal Medicine, Department of Primary Care and Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
9
|
Kawazoe M, Funakoshi S, Ishida S, Yoshimura C, Satoh A, Maeda T, Tsuji M, Yokota S, Tada K, Takahashi K, Ito K, Yasuno T, Fujii H, Okutsu S, Mukobara S, Kawanami D, Nabeshima S, Kondo S, Masutani K, Arima H. Effect of chronic kidney disease on the association between hyperuricemia and new-onset hypertension in the general Japanese population: ISSA-CKD study. J Clin Hypertens (Greenwich) 2021; 23:2071-2077. [PMID: 34806282 PMCID: PMC8696210 DOI: 10.1111/jch.14390] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/29/2021] [Accepted: 10/11/2021] [Indexed: 12/01/2022]
Abstract
We aimed to investigate the association between serum uric acid (SUA) level and development of hypertension as well as the interaction effect of chronic kidney disease (CKD) on this relationship in the general Japanese population. We included 7895 participants aged ≥30 years from the ISSA‐CKD study, a population‐based retrospective cohort study that used annual health check‐up data of residents from Iki Island, Japan. After the exclusion of 1881 with l < 1‐year follow‐up, 2812 with hypertension at baseline, and 165 with missing information on SUA, a total of 3037 participants were enrolled in this analysis. Participants were divided into four groups according to the quartiles of SUA level at baseline, and multivariable‐adjusted hazard ratios for new‐onset hypertension were calculated. Stratified analyses were performed for each subgroup (defined by sex, age, alcohol intake, and CKD) to assess the interaction effects. During a mean follow‐up period of 4.4 years, 943 participants developed hypertension. The first quartile group was set as the reference group, and the multivariable‐adjusted hazard ratios (95% confidence interval) for new‐onset hypertension were 1.11 (0.90–1.36) in the second quartile, 1.25 (1.02–1.54) in the third quartile, and 1.35 (1.07–1.70) in the fourth quartile compared with those in the reference group (p = .007 for trend). The stratified analyses showed that the association between SUA and hypertension was significantly stronger in participants with CKD than in those without CKD (p = .035 for interaction). SUA level is an independent risk factor for new‐onset hypertension. This tendency was significantly stronger in participants with CKD.
Collapse
Affiliation(s)
- Miki Kawazoe
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Shunsuke Funakoshi
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Shintaro Ishida
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Chikara Yoshimura
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.,Department of Respiratory Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Atsushi Satoh
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Toshiki Maeda
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Masayoshi Tsuji
- Department of Lifestyle and Welfare Information, Kindai University Kyushu Junior College, Fukuoka, Japan
| | - Soichiro Yokota
- Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Division of Nephrology and Rheumatology, Fukuoka, Japan
| | - Kazuhiro Tada
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.,Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Division of Nephrology and Rheumatology, Fukuoka, Japan
| | - Koji Takahashi
- Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Division of Nephrology and Rheumatology, Fukuoka, Japan
| | - Kenji Ito
- Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Division of Nephrology and Rheumatology, Fukuoka, Japan
| | - Tetsuhiko Yasuno
- Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Division of Nephrology and Rheumatology, Fukuoka, Japan
| | - Hideyuki Fujii
- Department of Endocrinology and Diabetes Mellitus, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Shota Okutsu
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.,Department of General Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | | | - Daiji Kawanami
- Department of Endocrinology and Diabetes Mellitus, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Shigeki Nabeshima
- Department of General Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Seiji Kondo
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kosuke Masutani
- Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Division of Nephrology and Rheumatology, Fukuoka, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| |
Collapse
|
10
|
Yu C, Ren X, Pan L, Zhao H, Wang Y, Chang L, He H, Xi J, Shan G. Association between Serum Uric Acid and Hypertension in Han and Yugur of Gansu Province: The China National Health Survey. Kidney Blood Press Res 2021; 46:723-733. [PMID: 34518473 DOI: 10.1159/000518768] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/28/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Serum uric acid (SUA) has been found correlated with an increased risk of hypertension, but evidence is sparse regarding the association in Gansu Province, especially in Yugur people. This study aimed to explore the nonlinear relationship between SUA levels and hypertension in Han and Yugur people in China. METHODS The cross-sectional study samples (n = 5,327) were from the China National Health Survey (CNHS) in Gansu Province. Participants were selected using a multistage stratified cluster sampling method. SUA was measured by enzymatic methods. The restricted cubic spline regression was performed to evaluate the shape of the association. RESULTS The overall prevalence of hypertension and hyperuricemia was 28.4% and 17.0%, respectively, in this study. Comparing the highest (>416.4 μmol/L) to the lowest (<254.1 μmol/L) SUA level groups, the multivariable adjusted differences and 95% confidence intervals (CIs) in blood pressure (BP) were 6.15 (4.22, 8.08) mm Hg and 4.87 (3.51, 6.23) mm Hg for SBP and DBP in Han, and 2.22 (-0.73, 5.18) mm Hg and 2.56 (0.38, 4.75) mm Hg for SBP and DBP in Yugur people, respectively. The corresponding odds ratios (95% CIs) for hypertension were 3.16 (2.26, 4.43) and 2.37 (1.46, 3.89) in Han and Yugur people, respectively. The restricted cubic spline regression models illustrated that both BP level and the risk of hypertension increased with elevated SUA levels in Han and Yugur people. CONCLUSIONS SUA was significantly and independently associated with an increased risk of hypertension in Han and Yugur people. Prospective studies are needed to confirm these findings.
Collapse
Affiliation(s)
- Chengdong Yu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Xiaolan Ren
- Institute of Chronic and Noncommunicable Disease Control and Prevention, Gansu Provincial Centre for Disease Control and Prevention, Lanzhou, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Hongjun Zhao
- Institute of Chronic and Noncommunicable Disease Control and Prevention, Gansu Provincial Centre for Disease Control and Prevention, Lanzhou, China
| | - Ye Wang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Lijun Chang
- Institute of Chronic and Noncommunicable Disease Control and Prevention, Gansu Provincial Centre for Disease Control and Prevention, Lanzhou, China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Jin'en Xi
- Institute of Chronic and Noncommunicable Disease Control and Prevention, Gansu Provincial Centre for Disease Control and Prevention, Lanzhou, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| |
Collapse
|
11
|
Zhang L, Yang L, Wang C, Yuan T, Zhang D, Wei H, Li J, Lei Y, Sun L, Li X, Hua Y, Che H, Li Y. Individual and combined association analysis of famine exposure and serum uric acid with hypertension in the mid-aged and older adult: a population-based cross-sectional study. BMC Cardiovasc Disord 2021; 21:420. [PMID: 34488649 PMCID: PMC8420034 DOI: 10.1186/s12872-021-02230-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/30/2021] [Indexed: 01/02/2023] Open
Abstract
Background Malnutrition in early life may affect health in later life. The associations between malnutrition and serum uric acid (SUA) and hypertension were inconsistent. The present study aimed to investigate the individual and combined association between famine exposure and serum uric acid and hypertension in middle-aged and older Chinese. Methods Data were selected from the China Health and Retirement Longitudinal Study (CHARLS) Wave2011. The analytic sample included 9368 individuals aged 45 to 90. Differences between baseline characteristics and famine exposure/SUA level were evaluated using the Chi-square test, t-test, and F-test. Then, the differences in the prevalence of hypertension between characteristic groups was also estimated by the Chi-square and t-test. Finally, multivariable-adjusted logistic regression models examined association of famine exposure and serum uric acid with odds of prevalence of hypertension. Results A total of 9368 individuals were enrolled in the study, 4366 (46.61%) and 5002 (53.39%) were male and female, respectively. Among males, 459 (10.51%) had been exposed to the Chinese famine during the fetal stage, whereas 1760 (40.31%) and 1645 (37.68%) had been exposed to the famine during childhood and adolescence/adult stage, respectively. Among females, 635 (12.69%) had been exposed to the Chinese famine during the fetal stage, whereas 1988 (39.74%) and 1569 (31.37%) had been exposed to the famine during childhood and adolescence/adult stage, respectively. Regarding the participants with SUA level measurements, 290 (6.64%) reported having Hyperuricemia (HUA) in males and 234 (4.68%) in the females. Furthermore, 1357 (31.08%) reported having hypertension in male and 1619 (32.37%) in the female. In multivariable-adjusted model, famine exposure and serum uric acid were associated with prevalence of hypertension independently in total populations [(1) Model fourd, fatal exposed group vs non-exposed group: 1.25 (95% CI 1.03, 1.52); childhood-exposed group vs non-exposed group:1.60 (95% CI 1.37, 1.87); adolescence/adult exposed group vs non-exposed group: 2.87 (95% CI 2.44, 3.37), P for trend < 0.001; (2) Model four e, high vs normal:1.73 (95% CI 1.44, 2.08)]. When stratified by sex, the results in both males and females were similar to those in the total population. In general, interaction analysis in the multivariable-adjusted model, compared with the combination of normal SUA level and no-exposed famine stage, all groups trended towards higher odds of prevalence of hypertension [the greatest increase in odds, adolescence/adult exposed stage and high SUA level in total participants: OR4.34; 95%CI 3.24, 5.81; P for interaction < 0.001]. When stratified by sex, the results in both males and females were also similar to those in the total population. Conclusion Our data support a strongly positive individual and combined association of famine exposure and serum uric acid with hypertension in middle-aged and elderly Chinese.
Collapse
Affiliation(s)
- Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Huanhuan Wei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Hengying Che
- Department of Nursing, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Zheshan West Road, Yijishan District, Wuhu City, Anhui Province, People's Republic of China.
| | - Yuanzhen Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China.
| |
Collapse
|
12
|
Nie Q, Zhang X, Hao Z, Wang L, Liu H, Liu C, Wang Z, Song G. Impact of Serum Uric Acid Concentration on the Risk of Cardiovascular Disease: A Cohort Study Conducted in Northern China. Arq Bras Cardiol 2021; 117:666-675. [PMID: 34287570 PMCID: PMC8528365 DOI: 10.36660/abc.20200378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 11/04/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The results of previous studies of the relationship between serum uric acid (SUA) and the risk of cardiovascular disease (CVD) have been inconsistent due to confounding factors caused by other known cardiovascular risk factors. OBJECTIVES This study aimed to evaluate the relationship between SUA and incident CVD in middle-aged and elderly Chinese people, who were stratified according to body mass index (BMI). METHODS This study recruited 5,721 participants of 40-75 years of age, who were free of CVD at baseline and who underwent follow-up from 2008 to 2017. Participants were categorized in SUA quintiles. Cox proportional hazard and Kaplan-Meier survival analysis were used to compare CVD incidence among the SUA groups. The correlations between SUA and CVD incidence in groups with differing BMI and waist circumference (WC) were also analyzed. A P value <0.05 was considered statistically significant. RESULTS During a mean follow-up period of 7.6 years, CVD incidence increased with SUA (log-rank test p<0. 001). Compared with the first quintile, the adjusted hazard ratios (95% confidence interval (CI)) for the development of CVD were 1.08 (0.78-1.65), 1.17 (0.88-1.77), 1.47 (1.12-2.21), and 1.68 (1.28-2.44) for the second to fifth quintiles, respectively. This relationship was clearer in participants with normal BMI and WC. The adjusted hazard ratio for each 100 μmol/L increase in SUA was 1.13 (95% CI: 1.02-1.39) for CVD events. CONCLUSIONS High SUA is an independent risk factor for CVD in middle-aged and elderly northern Chinese people. This effect is maintained even after stratification according to measures of leanness/obesity.
Collapse
Affiliation(s)
- Qian Nie
- Hebei Medical University - Department of Internal Medicine, Shijiazhuang City - China
| | - Xuemei Zhang
- Hebei Medical University - Department of Internal Medicine, Shijiazhuang City - China
| | - Zhihua Hao
- Hebei General Hospital - Physical Examination Center, Shijiazhuang, Hebei - China
| | - Liqin Wang
- Hebei Medical University - School of Public Health, Shijiazhuang City, Hebei - China
| | - Huanxin Liu
- Hebei General Hospital - Physical Examination Center, Shijiazhuang, Hebei - China
| | - Chenghao Liu
- Hebei General Hospital - Physical Examination Center, Shijiazhuang, Hebei - China
| | - Zhongli Wang
- Hebei General Hospital - Physical Examination Center, Shijiazhuang, Hebei - China
| | - Guangyao Song
- Hebei Medical University - Department of Internal Medicine, Shijiazhuang City - China.,Hebei General Hospital - Hebei Key Laboratory of Metabolic Diseases, Shijiazhuang - China
| |
Collapse
|
13
|
Kim W, Go TH, Kang DO, Lee J, Choi JY, Roh SY, Na JO, Choi CU, Rha SW, Park CG, Seo HS, Kang DR, Kim JY, Kim EJ. Age and sex dependent association of uric acid and incident hypertension. Nutr Metab Cardiovasc Dis 2021; 31:1200-1208. [PMID: 33618926 DOI: 10.1016/j.numecd.2020.12.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 12/03/2020] [Accepted: 12/11/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS A previous meta-analysis suggested that the relationship between hyperuricemia and hypertension may be stronger in younger individuals and women. We aimed to investigate the age and sex dependent association of uric acid (UA) and incident hypertension. METHODS AND RESULTS We analyzed data from the Health Examinees Study, a community-based prospective cohort study conducted in Korea from 2004 to 2013. It included 29,088 non-hypertensive subjects aged 40-79 (age, 52.5 ± 7.8 years; men, 31.4%) who had serum UA measurement and participated in the follow-up survey. The risk factors of hypertension were assessed using Cox regression. Over a mean 3.8 years of follow-up, 1388 men (15.2%) and 1942 women (9.7%) were newly diagnosed with hypertension. Upon age- and sex-based stratification, the risk of hypertension was highest in hyperuricemic subjects aged 40-49 years (HR: women, 2.16; men, 1.30). Across the entire cohort, the risk of incident hypertension was higher in groups with higher serum UA levels, and highest in women aged 40-49 years (HR, 1.44; P < 0.001). On multivariable linear regression analysis, the higher the baseline serum UA level, the greater the increase in blood pressure during follow-up, and this effect was strongest in women aged 40-49 years (β = 0.87 and P < 0.01 for systolic blood pressure). CONCLUSIONS The relationship between uric acid and incident hypertension tended to be dependent on age and sex. Younger women are at highest risk of UA-related incident hypertension.
Collapse
Affiliation(s)
- Woohyeun Kim
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Tae Hwa Go
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Dong Oh Kang
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Jieun Lee
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Jah Yeon Choi
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Seung-Young Roh
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Jin Oh Na
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Cheol Ung Choi
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Seung-Woon Rha
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Chang Gyu Park
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Hong Seog Seo
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Dae Ryong Kang
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jang-Young Kim
- Department of Cardiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Eung Ju Kim
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea.
| |
Collapse
|
14
|
Marković-Boras M, Čaušević A, Ćurlin M. A relation of serum homocysteine and uric acid in Bosnian diabetic patients with acute myocardial infarction. J Med Biochem 2021; 40:261-269. [PMID: 34177370 PMCID: PMC8199414 DOI: 10.5937/jomb0-28391] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/10/2020] [Indexed: 12/31/2022] Open
Abstract
Background: Coronary artery disease as a consequence of atherosclerosis is the most common cause of morbidity and mortality in type 2 Diabetes Mellitus (DM) patients. Homocysteine (HCY), as one of the risk factors, and uric acid (UA) as the most common antioxidant in serum have their roles in the processes of inflammation and atherogenesis, which underlie the pathogenesis of acute myocardial infarction (AMI). The effect of HCY in cardiovascular disease is thought to be manifested primarily through oxidative damage, implying a potential correlation between the HCY level and antioxidant status. Since the data related to the diagnostic significance of both HCY and UA in diabetic patients with AMI are conflicting, and so far not reported in Bosnian patients, this research aimed to examine the association of HCY and UA levels with glomerular filtration rate (eGFR) and explore the pathophysiological significance of these data in Bosnian diabetic patients with AMI. Methods: This prospective research included 52 DM type 2 patients diagnosed with AMI. Blood samples were taken on admission and used for biochemical analysis. Results of the biochemical analyses were statistically analysed. Results: Elevated HCY and UA levels were observed in diabetic patients. Females have higher HCY compared to males. A positive correlation was revealed between HCY and UA and was confirmed with different HCY levels in subgroups with different UA level. A negative correlation was observed between UA and HbA1c, as well as between both HCY and UA with eGFR. Conclusions: These results contribute to the clarification of the biochemical mechanisms characteristic in AMI patients with DM. According to these results, we believe that joint measurement of HCY and UA could enable a better assessment of the prognosis for this group of patients. This kind of assessment, as well as regression analysis, can identify high-risk patients at an earlier stage when appropriate interventions can influence a better outcome in such patients.
Collapse
Affiliation(s)
- Marijana Marković-Boras
- University Clinical Hospital Mostar, Department of Laboratory Medicine, Mostar, Bosnia and Herzegovina
| | - Adlija Čaušević
- University of Sarajevo, Faculty of Pharmacy, Department of Biochemistry and Clinical Analysis, Sarajevo, Bosnia and Herzegovina
| | - Marina Ćurlin
- University of Mostar, Faculty of Health Studies, Mostar, Bosnia and Herzegovina
| |
Collapse
|
15
|
Kawamoto R, Ninomiya D, Akase T, Asuka K, Kumagi T. High serum uric acid within the normal range is a useful predictor of hypertension among Japanese community-dwelling elderly women. Clin Hypertens 2020; 26:20. [PMID: 33072398 PMCID: PMC7560071 DOI: 10.1186/s40885-020-00155-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 10/02/2020] [Indexed: 02/07/2023] Open
Abstract
Background The risk associated with serum uric acid (SUA) levels when within the normal range is unknown. This study aims to examine whether SUA within the normal range is a predictor of hypertension. Methods The subjects comprised 704 men aged 71 ± 9 (mean ± standard deviation) years and 946 women aged 70 ± 8 years recruited for a survey at the community based annual medical check-up. The main outcome was the presence of hypertension (antihypertensive medication and/or having SBP ≥140 mmHg and/or DBP ≥90 mmHg). Results At baseline, 467 (66.3%) men and 608 (64.3%) women had hypertension. Comparing to lowest quartile in women (SUA-1, uric acid < 4.1 mg/dL), the unadjusted odds ratios (ORs) [95% confidence interval (CI)] for hypertension of SUA-2 (4.1 to 4.7 mg/dL), SUA-3 (4.8 to 5.4 mg/dL), and SUA-4 (≥5.5 mg/dL) were 1.11 (0.78–1.59), 1.75 (1.20–2.55), and 1.89 (1.30–2.77), respectively. These associations were apparent even after adjustments for age, but ORs were attenuated after adjusting for all confounding factors. During a follow-up of 3.0 years, there were 35 (24.0%) hypertension cases in men and 51 (20.8%) in women. In women only, a significant association between increased SUA categories and incidence of hypertension was observed, and the multivariate-ORs (95% (CI) for incident hypertension of SUA-3 (4.5–5.2 mg/dL) and SUA-4 (≥5.3 mg/dL) were 2.23 (0.81–6.11) and 3.84 (1.36–10.8), respectively. Conclusions These results suggest that baseline SUA within the normal range could be an important predictor for incidence of hypertension in Japanese community-dwelling elderly women.
Collapse
Affiliation(s)
- Ryuichi Kawamoto
- Department of Community Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Japan.,Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, Japan
| | - Daisuke Ninomiya
- Department of Community Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Japan.,Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, Japan
| | - Taichi Akase
- Department of Community Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Japan.,Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, Japan
| | - Kikuchi Asuka
- Department of Community Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Japan.,Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, Japan
| | - Teru Kumagi
- Department of Community Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Japan
| |
Collapse
|
16
|
Kanbay M, Girerd N, Machu JL, Bozec E, Duarte K, Boivin JM, Wagner S, Ferreira JP, Zannad F, Rossignol P. Impact of Uric Acid on Hypertension Occurrence and Target Organ Damage: Insights From the STANISLAS Cohort With a 20-Year Follow-up. Am J Hypertens 2020; 33:869-878. [PMID: 32267470 DOI: 10.1093/ajh/hpaa030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/20/2020] [Accepted: 04/07/2020] [Indexed: 12/15/2022] Open
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 < 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 < 0.05), and the association of SUA with eGFR decline was age dependent (the decline in eGFR being greater in older subjects; interactionp < 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 < 0.02). CONCLUSIONS Increased SUA is associated with the development of HTN and vascular/renal TOD in initially healthy midlife subjects.
Collapse
Affiliation(s)
- Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey
| | - Nicolas Girerd
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Jean-Loup Machu
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Erwan Bozec
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Kevin Duarte
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Jean-Marc Boivin
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Sandra Wagner
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - João Pedro Ferreira
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Faiez Zannad
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Patrick Rossignol
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| |
Collapse
|
17
|
Yan W, Sun G, Luo A, Lin S, Wang J, Zhang Q, Jiang J, Zhang M, Wang F, Tan W. Serum uric acid is independently associated with aortic arch calcification in a cross-sectional study of middle-aged and elderly women. Nutr Metab Cardiovasc Dis 2020; 30:932-938. [PMID: 32402584 DOI: 10.1016/j.numecd.2020.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/11/2020] [Accepted: 02/21/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND AIMS The increased serum uric acid (SUA) level is associated with the prevalence of cardiovascular disease (CVD) risks. Aortic arch calcification (AAC) reflects subclinical coronary atherosclerosis and is linked to subsequent cardiovascular morbidity and mortality risks closely. To better understand the role of SUA on arteriosclerosis and CVD, we aim to determine the association between SUA and the presence of AAC. METHODS AND RESULTS A total of 5920 individuals aged >45 years old without prior CVD disease were included. The prevalence rate of AAC was 14.4% in all participants and a significantly increasing trend for AAC prevalence rate was found across the SUA tertiles (p < 0.001 for trend). Subsequent subgroup analyses revealed that this positive association trend was only significant in female subjects. After adjusting for confounders, SUA is an independent predictor for the presence of AAC in overall participants and in women. CONCLUSION SUA is independently associated with AAC in middle-aged and elderly population, especially in the women. More research needs to determine whether lower thresholds for CVD risk screening for those middle-aged and elderly women with higher SUA tertile even without hyperuricemia are warranted.
Collapse
Affiliation(s)
- Wei Yan
- Division of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, China
| | - Guoming Sun
- Division of Rheumatology, The Affiliated Changzhou NO.2 People's Hospital of Nanjing Medical University, China
| | - Aishu Luo
- Division of Rheumatology, Yancheng First Hospital, Jiangsu Province, China
| | - Shiyu Lin
- Division of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, China
| | - Jianan Wang
- Division of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, China
| | - Qiande Zhang
- Institute of Integrated Chinese and Western Medicine, Nanjing Medical University, China
| | - Jintao Jiang
- Institute of Integrated Chinese and Western Medicine, Nanjing Medical University, China
| | - Miaojia Zhang
- Division of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, China
| | - Fang Wang
- Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, China
| | - Wenfeng Tan
- Division of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, China.
| |
Collapse
|
18
|
Wang C, Yan W, Wang H, Zhu J, Chen H. APOE polymorphism is associated with blood lipid and serum uric acid metabolism in hypertension or coronary heart disease in a Chinese population. Pharmacogenomics 2019; 20:1021-1031. [PMID: 31559922 DOI: 10.2217/pgs-2019-0048] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To explore the association of APOE polymorphism (rs7412:526C>T and rs429358:388T>C) with glucose, lipid and serum uric acid (UA) metabolism in patients with hypertension or coronary heart disease (CHD). Methods: A total of 544 patients with hypertension or CHD were selected for this study from March 2017 to January 2018. According to the APOE genotypes (excluding the E2/E4 genotype), the subjects were divided into three groups (E2/E2+E2/E3 genotypes, E3/E3 genotype [the wild-type] and E3/E4+E4/E4 genotypes) and the difference of metabolism among the three groups was compared. Results: There were significant differences in total cholesterol (TC), triglycerides, low-density lipoprotein (LDL), high-density lipoprotein and serum UA levels among the three groups. Compared with APOE E3 homozygote, APOE E4 carriers possessed higher TC, triglycerides and LDL levels, whereas APOE E2 carriers had higher high-density lipoprotein level, lower TC and LDL levels. Furthermore, multivariate logistic regression analysis found that setting E3/E3 genotype as the reference group, the carriers of APOE E4 allele (E3/E4+E4/E4 genotypes) were significantly related to hypertriglyceridemia, and APOE E2 allele (E2/E2+E2/E3 genotypes) was significantly correlated with hyperuricemia. Conclusion: APOE polymorphism was associated with blood lipid and serum UA metabolism in patients with hypertension or CHD. Compared with APOE E3 homozygote, APOE E4 allele was related to elevated triglycerides, and APOE E2 allele was correlated with increased serum UA level.
Collapse
Affiliation(s)
- Canwang Wang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, PR China
| | - Wanli Yan
- Fujian Provincial Hospital, 134 East Street, Fuzhou, Fujian 350001, PR China
| | - Huan Wang
- Fujian Provincial Hospital, 134 East Street, Fuzhou, Fujian 350001, PR China
| | - Jingkang Zhu
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, PR China
| | - Hui Chen
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, PR China
- Fujian Provincial Hospital, 134 East Street, Fuzhou, Fujian 350001, PR China
| |
Collapse
|
19
|
Liu J, Wang K, Liu H, Zhao H, Zhao X, Lan Y, Huang W, Wang H. Relationship between carotid-femoral pulse wave velocity and uric acid in subjects with hypertension and hyperuricemia. Endocr J 2019; 66:629-636. [PMID: 31092739 DOI: 10.1507/endocrj.ej18-0570] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Increasing of arterial stiffness is the pathophysiological characteristic of hypertension. Carotid-femoral pulse wave velocity (CF-PWV) is an index of arterial stiffness. Serum uric acid has been found to be involved the development of hypertension. We investigated the relationship between CF-PWV and serum uric acid in subjects with hypertension and hyperuricemia. 651 subjects (M/F 271/380) were divided into four groups, group 1: subjects without hypertension and hyperuricemia; group 2: hypertension subjects without hyperuricemia; group 3: hyperuricemia subjects without hypertension; group 4: subjects with hypertension and hyperuricemia. CF-PWV was measured by Complior apparatus. Results showed that levels of CF-PWV (10.75 ± 2.03 vs. 10.06 ± 1.98 m/s, p < 0.001) and serum uric acid (319.33 ± 80.12 vs. 298.78 ± 74.88 umol/L, p = 0.001) were significantly higher in hypertensive (groups 2 + 4) group than in normotensive (groups 1 + 3) group. CF-PWV was significantly higher in group 4 than group 1, group 2 and group 3 (ANOVA analysis: F = 13.348, p < 0.001; 11.78 ± 2.10 vs. 9.98 ± 1.98, 10.52 ± 1.93, 10.56 ± 1.99 m/s, all p < 0.05, respectively). There was positive correlation between CF-PWV and serum uric acid in entire study group (r = 0.187, p < 0.001), even after adjusting for gender, body mass index, systolic blood pressure (SBP) and diastolic blood pressure (r = 0.100, p = 0.015). Multiple linear regressions showed that SBP, age, benzbromarone, statin and serum uric acid were independent associating factors of CFPWV in all subjects (β = 0.310, p < 0.001; β = 0.330, p < 0.001; β = 0.172, p = 0.002; β = -0.143, p = 0.006; β = 0.126, p = 0.027; respectively). In conclusions, CF-PWV was significantly higher in hypertension subjects with hyperuricemia compared to hypertension without hyperuricemia subjects, and serum uric acid was an independent associating factor of CF-PWV.
Collapse
Affiliation(s)
- Jinbo Liu
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing 100144, P. R. of China
| | - Kuanting Wang
- Department of Rheumatology and Immunology, Peking University Shougang Hospital, Beijing 100144, P. R. of China
| | - Huan Liu
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing 100144, P. R. of China
| | - Hongwei Zhao
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing 100144, P. R. of China
| | - Xiaoxiao Zhao
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing 100144, P. R. of China
| | - Yang Lan
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing 100144, P. R. of China
| | - Wei Huang
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing 100144, P. R. of China
| | - Hongyu Wang
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing 100144, P. R. of China
| |
Collapse
|
20
|
Impact of serum uric acid on incident hypertension in a worksite population of Japanese men. J Hypertens 2019; 36:1499-1505. [PMID: 29746372 DOI: 10.1097/hjh.0000000000001743] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Higher levels of serum uric acid are associated with an increased risk of cardiovascular diseases, which may be confounded by comorbidities. We investigated the effects of serum uric acid on the risk of hypertension in Japanese men at a worksite. METHODS We evaluated a total of 2335 Japanese male workers without hypertension who ranged in age from 18 to 64 years at a worksite in 2009. These men were followed for 6 years from 2009 to 2015. RESULTS During the follow-up period, 380 individuals developed hypertension. The odds ratio for the incident hypertension was estimated according to quartiles of serum uric acid levels of 5.1 or less, 5.2-5.8, 5.9-6.6, and at least 6.7 mg/dl. The multivariable-adjusted risk of incident hypertension was significantly higher in the highest serum uric acid quartile than in the lowest: odds ratio 1.00 (reference) for the lowest quartile, 1.34 (0.91-1.97) for the second quartile, 1.42 (0.97-2.06) for the third quartile, and 1.65 (1.14-2.40) for the highest quartile. In stratified analyses, the association between serum uric acid and incident hypertension was significant in the patients of aged below 45 years and without comorbidities, namely diabetes and low levels of high-density lipoprotein-cholesterol. CONCLUSIONS Serum uric acid levels were associated with the future incidence of hypertension, and the association was observed in the younger individuals, those without diabetes, and those with preserved high-density lipoprotein cholesterol levels in a worksite population of Japanese men.
Collapse
|
21
|
Lin X, Wang X, Li X, Song L, Meng Z, Yang Q, Zhang W, Gao Y, Yang Z, Cai H, Bian B, Li Y, Yu X, Du X, Xu S, Nie J, Liu M, Sun J, Zhang Q, Gao Y, Song K, Wang X, Zhao L, Fan Y. Gender- and Age-Specific Differences in the Association of Hyperuricemia and Hypertension: A Cross-Sectional Study. Int J Endocrinol 2019; 2019:7545137. [PMID: 30944567 PMCID: PMC6421730 DOI: 10.1155/2019/7545137] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 01/21/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Both hyperuricemia and hypertension have important clinical implications, but their relationship in terms of gender and age is still a matter of debate. In this study, we aimed to explore gender- and age-specific differences in this association between hyperuricemia and hypertension in a Chinese population. METHODS A total of 78596 ostensibly healthy subjects (47781 men and 30815 women) were recruited. The association between hyperuricemia and hypertension was analyzed by multivariate logistic regression, and the analyses were stratified by gender and age. RESULTS Overall prevalence of hypertension and hyperuricemia was significantly higher in males than in females. Increasing trends of hypertension prevalence in both genders as well as hyperuricemia prevalence in females were found along with aging. However, males showed a reduced trend in hyperuricemia prevalence with aging. Higher hypertension and hyperuricemia prevalence was found in young and middle-aged men than in women, but not in elderly people older than 70 years. Significantly increased risk of hypertension from hyperuricemia was found only in men with an adjusted odds ratio of 1.131 (P < 0.01), especially in the middle-aged male participants. However, such significant results were not found in women. Similarly, hyperuricemia was also an independent risk factor of increased systolic blood pressure and diastolic blood pressure in males, but not in females. CONCLUSION We observed significantly higher overall prevalence of hyperuricemia and hypertension in men than in women. Men with hyperuricemia (particularly in middle age) had a significantly increased susceptibility of hypertension, while this significant association was not observed in women.
Collapse
Affiliation(s)
- Xiaoyun Lin
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiqian Wang
- Department of Nephrology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Li
- College of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lili Song
- College of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhaowei Meng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Qing Yang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Wenjuan Zhang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuxia Gao
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhenwen Yang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Heng Cai
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Bo Bian
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yongle Li
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xuefang Yu
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Du
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Shaopeng Xu
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing Nie
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Liu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Jinhong Sun
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, China
| | - Qing Zhang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, China
| | - Ying Gao
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, China
| | - Kun Song
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, China
| | - Xing Wang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Zhao
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Yaguang Fan
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| |
Collapse
|
22
|
Lee SW, Kim HC, Nam C, Lee HY, Ahn SV, Oh YA, Suh I. Age-differential association between serum uric acid and incident hypertension. Hypertens Res 2018; 42:428-437. [PMID: 30559402 DOI: 10.1038/s41440-018-0168-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 08/16/2018] [Accepted: 09/06/2018] [Indexed: 02/07/2023]
Abstract
Increasing evidence suggests a positive association between the serum uric acid (SUA) level and incident hypertension. However, the association has been inconsistent based on age, sex, body mass index, and lipid profiles. Thus, we investigated whether there is an interaction between SUA and other risk factors on incident hypertension in the Korean general population. In this study, 808 participants aged 40-79 years were included. They were free of hypertension and major cardiovascular disease at baseline. Incident hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg, diastolic blood pressure (DBP) ≥ 90 mmHg, or use of antihypertensive medication. To investigate whether the association between SUA and incident hypertension is modified by other risk factors for hypertension, a generalized linear model and Z test were used. During the mean follow-up of 3.3 years, 11.5% of men and 10.7% of women developed hypertension. The association between SUA and incident hypertension was inconsistent according to participant age (p for interaction = 0.009). The association between SUA level and incident hypertension was positively significant among people aged < 55 years (relative risk 1.74 per 1.0 mg/dL of SUA; p = 0.002), but there was no significant association among people aged ≥ 55 years (p = 0.894). In a secondary analysis, the SUA level was not associated with an increase in SBP, but positively associated with DBP. We observed an age-differential association between SUA level and incident hypertension among Koreans. An increased SUA level can be a trigger for hypertension through early vascular changes in the middle-aged population.
Collapse
Affiliation(s)
- Seung Won Lee
- Department of Public Health, Yonsei University Graduate School, Seoul, Republic of Korea.,Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyeon Chang Kim
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Republic of Korea. .,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Chungmo Nam
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hae-Young Lee
- Department of internal medicine, Division of Cardiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Song Vogue Ahn
- Department of Health Convergence, Ewha Woman's University, Seoul, Republic of Korea
| | - Young A Oh
- Korean Human Resource Development Institute for Health and Welfare, Cheongju, Republic of Korea
| | - Il Suh
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
23
|
Kim SK. Interrelationship of Uric Acid, Gout, and Metabolic Syndrome: Focus on Hypertension, Cardiovascular Disease, and Insulin Resistance. JOURNAL OF RHEUMATIC DISEASES 2018. [DOI: 10.4078/jrd.2018.25.1.19] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Seong-Kyu Kim
- Division of Rheumatology, Department of Internal Medicine, Arthritis and Autoimmunity Research Center, Catholic University of Daegu School of Medicine, Daegu, Korea
| |
Collapse
|
24
|
Cheng W, Wen S, Wang Y, Qian Z, Tan Y, Li H, Hou Y, Hu H, Golledge J, Yang G. The association between serum uric acid and blood pressure in different age groups in a healthy Chinese cohort. Medicine (Baltimore) 2017; 96:e8953. [PMID: 29390287 PMCID: PMC5815699 DOI: 10.1097/md.0000000000008953] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
High serum uric acid (sUA) has been reported to be a risk factor for hypertension however, whether this is the case for all age groups is not clear. We examined the association between sUA concentrations and systolic and diastolic blood pressure (SBP and DBP) in different age groups in a cohort of healthy Chinese participants.A total of 1082 healthy participants aged from 41 to 70 years were included. sUA concentration was measured by the uricase-peroxidase method. SBP and DBP were assessed using mercury sphygmomanometry. Hypertension was defined as SBP ≥140 mm Hg or DBP ≥90 mm Hg. Hyperuricemia (HUA) was defined as sUA concentration of >7 mg/dL in men and >6 mg/dL in women. The association between sUA concentration and SBP and DBP was examined using Pearson's correlation test, multivariate linear regression, and logistic regression analysis.The prevalence of hypertension and HUA increased with age (P < .001). Hypertension was more common in participants that had HUA than in those that did not (38.95% vs 30.16%, P = .02). Higher sUA was significantly associated with higher SBP and DBP in the 41- to 50-year-old participants (SBP, β = 0.35, P < .001; DBP, β = .29, P < .001; after adjustment for age, sex, total cholesterol, estimated glomerular filtration rate, and fasting plasma glucose). HUA was also a risk factor for hypertension in this age group (odds ratio 1.425, 95% confidence interval, 1.217-1.668, P < .001). There was no association between sUA concentration and SBP and DBP in the other age groups.In this population of healthy Chinese participants, sUA concentration was positively associated with hypertension only in the 41- to 50-year-old group. Lowering uric acid in this age group may help to reduce the incidence of hypertension.
Collapse
Affiliation(s)
- Wenjuan Cheng
- Department of Geriatric Cardiology, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Shiling Wen
- Department of Geriatric Cardiology, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Yutang Wang
- Biomedical Science School of Applied and Biomedical Sciences, Federation University Australia, Mt Helen, Victoria, Australia
| | - Zhiping Qian
- Department of Cardiology, Ganzi Autonomous Prefecture Hospital, Kangding, Sichuan Province, China
| | - Yuyao Tan
- Department of Cardiology, Ganzi Autonomous Prefecture Hospital, Kangding, Sichuan Province, China
| | - Hongying Li
- Department of Geriatric Cardiology, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Yueli Hou
- Department of Geriatric Cardiology, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Haiyang Hu
- Department of Geriatric Cardiology, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Jonathan Golledge
- The Vascular Biology Unit, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
- Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Queensland, Australia
| | - Guang Yang
- Department of Geriatric Cardiology, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| |
Collapse
|
25
|
Sharaf El Din UA, Salem MM, Abdulazim DO. Uric acid in the pathogenesis of metabolic, renal, and cardiovascular diseases: A review. J Adv Res 2017; 8:537-548. [PMID: 28748119 PMCID: PMC5512153 DOI: 10.1016/j.jare.2016.11.004] [Citation(s) in RCA: 218] [Impact Index Per Article: 31.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 11/26/2016] [Accepted: 11/27/2016] [Indexed: 02/07/2023] Open
Abstract
The association between uric acid (UA) on one side and systemic hypertension (Htn), dyslipidemia, glucose intolerance, overweight, fatty liver, renal disease and cardiovascular disease (CVD) on the other side is well recognized. However, the causal relationship between UA and these different clinical problems is still debatable. The recent years have witnessed hundreds of experimental and clinical trials that favored the opinion that UA is a probable player in the pathogenesis of these disease entities. These studies disclosed the strong association between hyperuricemia and metabolic syndrome (MS), obesity, Htn, type 2 diabetes mellitus (DM), non-alcoholic fatty liver disease, hypertriglyceridemia, acute kidney injury, chronic kidney disease (CKD), coronary heart disease (CHD), heart failure and increased mortality among cardiac and CKD patients. The association between UA and nephrolithiasis or preeclampsia is a non-debatable association. Recent experimental trials have disclosed different changes in enzyme activities induced by UA. Nitric oxide (NO) synthase, adenosine monophosphate kinase (AMPK), adenosine monophosphate dehydrogenase (AMPD), and nicotinamide adenine dinucleotide phosphate (NADPH)-oxidase are affected by UA. These changes in enzymatic activities can lead to the observed biochemical and pathological changes associated with UA. The recent experimental, clinical, interventional, and epidemiologic trials favor the concept of a causative role of UA in the pathogenesis of MS, renal, and CVDs.
Collapse
Affiliation(s)
- Usama A.A. Sharaf El Din
- Nephrology Unit, Internal Medicine Department, School of Medicine, Cairo University, Egypt
- Corresponding author. Fax: +20 222753890.
| | - Mona M. Salem
- Endocrinology Unit, Internal Medicine Department, School of Medicine, Cairo University, Egypt
| | - Dina O. Abdulazim
- Rheumatology and Rehabilitation Department, School of Medicine, Cairo University, Egypt
| |
Collapse
|
26
|
Sex-specific metabolic profiles of androgens and its main binding protein SHBG in a middle aged population without diabetes. Sci Rep 2017; 7:2235. [PMID: 28533544 PMCID: PMC5440388 DOI: 10.1038/s41598-017-02367-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 04/10/2017] [Indexed: 01/21/2023] Open
Abstract
The role of androgens in metabolism with respect to sex-specific disease associations is poorly understood. Therefore, we aimed to provide molecular signatures in plasma and urine of androgen action in a sex-specific manner using state-of-the-art metabolomics techniques. Our study population consisted of 430 men and 343 women, aged 20-80 years, who were recruited for the cross-sectional population-based Study of Health in Pomerania (SHIP-TREND), Germany. We used linear regression models to identify associations between testosterone, androstenedione and dehydroepiandrosterone-sulfate (DHEAS) as well as sex hormone-binding globulin and plasma or urine metabolites measured by mass spectrometry. The analyses revealed major sex-specific differences in androgen-associated metabolites, particularly for levels of urate, lipids and metabolic surrogates of lifestyle factors, like cotinine or piperine. In women, in particular in the postmenopausal state, androgens showed a greater impact on the metabolome than in men (especially DHEAS and lipids were highly related in women). We observed a novel association of androstenedione on the metabolism of biogenic amines and only a small sex-overlap of associations within steroid metabolism. The present study yields new insights in the interaction between androgens and metabolism, especially about their implication in female metabolism.
Collapse
|
27
|
Xie JX, Hayek SS. Is it Time to Find a Role for Uric Acid Levels in the Prevention and Management of Hypertension. Am J Hypertens 2017; 30:16-18. [PMID: 27940429 DOI: 10.1093/ajh/hpw139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 10/11/2016] [Accepted: 10/21/2016] [Indexed: 01/02/2023] Open
Affiliation(s)
- Joe X Xie
- Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Salim S Hayek
- Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
| |
Collapse
|