1
|
Wang C, Qin P, Liu Y, Wang L, Xu S, Chen H, Dai S, Zhao P, Hu F, Lou Y. Association between hyperuricemia and hypertension and the mediatory role of obesity: a large cohort study in China. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20220241. [PMID: 37610925 PMCID: PMC10443908 DOI: 10.1590/1806-9282.20220241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 08/25/2023]
Abstract
OBJECTIVE This study aimed to investigate the sex-specific association between hyperuricemia and the risk of hypertension and whether obesity mediates this association. METHODS This study included 31,395 (47.0% women) adults without hypertension, cardiovascular disease, or cancer at baseline who completed at least one follow-up annual examination between 2009 and 2016. Cox regression models were performed to calculate hazard ratios and 95% confidence intervals. Mediation analysis was conducted to estimate the effect of body mass index on the association between hyperuricemia and hypertension. RESULTS During a median 2.9-year follow-up, hyperuricemia was significantly associated with a higher risk of hypertension (HR 1.15, 95%CI 1.07-1.24 for all participants; HR 1.12, 95%CI 1.03-1.22 for men; and HR 1.23, 95%CI 1.02-1.48 for women) after adjustment for potential confounders. Additional adjustment for body mass index attenuated this association (HR 1.09, 95%CI 1.08-1.10 for all participants; HR 1.07; 95%CI 0.98-1.16 for men; HR 1.18; 95%CI 0.96-1.44 for women). Mediation analysis showed that BMI partially mediated the relationship between hyperuricemia and incident hypertension (indirect effect HR 1.09, 95%CI 1.08-1.10; direct effect: HR 1.08, 95%CI 1.02-1.15). The percentage of the mediation effect was 53.2% (95%CI 37.9-84.5). CONCLUSION Hyperuricemia is associated with a risk of hypertension in both sexes, and BMI partially mediates hyperuricemia-related incident hypertension.
Collapse
Affiliation(s)
- Changyi Wang
- Shenzhen Nanshan Center for Chronic Disease, Department of Non-communicable Disease Prevention and Control - Shenzhen, China
- Zunyi Medical University, School of Public Health - Zunyi, China
| | - Pei Qin
- Shenzhen University, Health Science Center, School of Public Health, Department of Biostatistics and Epidemiology - Shenzhen, China
| | - Yinxing Liu
- Shenzhen Nanshan Center for Chronic Disease, Department of Non-communicable Disease Prevention and Control - Shenzhen, China
- Zunyi Medical University, School of Public Health - Zunyi, China
| | - Li Wang
- Shenzhen Nanshan Center for Chronic Disease, Department of Non-communicable Disease Prevention and Control - Shenzhen, China
| | - Shan Xu
- Shenzhen Nanshan Center for Chronic Disease, Department of Non-communicable Disease Prevention and Control - Shenzhen, China
| | - Hongen Chen
- Shenzhen Nanshan Center for Chronic Disease, Department of Non-communicable Disease Prevention and Control - Shenzhen, China
| | - Shuhong Dai
- Shenzhen Nanshan Center for Chronic Disease, Department of Non-communicable Disease Prevention and Control - Shenzhen, China
| | - Ping Zhao
- Beijing Xiaotangshan Hospital, Department of Health Management - Beijing, China
| | - Fulan Hu
- Shenzhen University, Health Science Center, School of Public Health, Department of Biostatistics and Epidemiology - Shenzhen, China
| | - Yanmei Lou
- Beijing Xiaotangshan Hospital, Department of Health Management - Beijing, China
| |
Collapse
|
2
|
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
|
3
|
Liu L, Zhang X, Qie R, Han M, Li Q, Zhang L, Zhan S, Zhang J, Zhang C, Hong F. Dose-response association between serum uric acid levels and incident hypertension: a systematic review and meta-analysis of 17 prospective cohort studies of 32 thousand participants. Acta Cardiol 2021; 76:748-753. [PMID: 32539677 DOI: 10.1080/00015385.2020.1779476] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Various magnitudes of the risk of incident hypertension (IHTN) have been reported to be associated with increased serum uric acid (SUA) levels in observational studies, however, whether a dose-response relation exists is unclear. We aimed to quantitatively evaluate the SUA-IHTN association. METHODS We searched the PubMed and Embase databases for relevant articles published prior to 21 October 2019. Random-effects models were used to estimate the summary relative risks (RRs) and 95% confidence intervals (CIs) of the IHTN risk in relation to SUA levels. We used restricted cubic splines to model the dose-response association between SUA levels and IHTN. RESULTS A total of 17 articles (17 prospective cohort studies) including 321,716 adults and 65,890 IHTN cases were identified. The pooled RR was 1.10 (95% CI 1.07-1.13; I2=90.7%; n = 17) per 1 mg/dL change in the SUA level. In addition, we found evidence of a linear and positive dose-response association between SUA levels and IHTN (Pnon-linearity = 0.069). The results of the subgroup and sensitivity analyses were consistent with those of the primary analysis. CONCLUSION These data suggested that people with higher SUA levels had a higher IHTN risk. SUA levels need to be controlled to reduce or eliminate the risk of IHTN associated with SUA levels. Clinical trial studies or diagnostic studies are needed to determine the optimal cut-off point for SUA.
Collapse
Affiliation(s)
- Leilei Liu
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Xiao Zhang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Ranran Qie
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Minghui Han
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Quanman Li
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Linyuan Zhang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Shaohui Zhan
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Juntao Zhang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Cailiang Zhang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Feng Hong
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| |
Collapse
|
4
|
Doğru S, Yaşar E, Yeşilkaya A. Uric acid can enhance MAPK pathway-mediated proliferation in rat primary vascular smooth muscle cells via controlling of mitochondria and caspase-dependent cell death. J Recept Signal Transduct Res 2021; 42:293-301. [PMID: 34057027 DOI: 10.1080/10799893.2021.1931320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Hyperuricemia may be a risk factor for cardiovascular diseases such as hypertension and atherosclerosis, but the mechanisms underlying uric acid-induced pathological conditions remain unknown. In this study, we investigated the effect of short time and long-term administration of increasing uric acid concentrations on cell viability, proliferative and apoptotic pathways in vascular smooth muscle cells (VSMCs). Cell viability/proliferation was determined with WST-1 assay. Expression levels of mitogen-activated protein kinases (MAPKs) (phosphorylated (p)-p38 and p-p44/42 MAPK), extrinsic (caspase 3, caspase 8), and intrinsic (B-cell lymphoma-extra-large (Bcl-xL)) apoptotic pathway proteins were measured by Western blotting. In order to assess the proliferative effects of uric acid incubations on VSMCs, we monitored the proliferative/apoptosis signaling pathways for up to 24 h. Our results indicated that uric acid increases cell viability at time and dose-dependently in VSMCs. Immunoblotting results showed that uric acid treatment elevated the expression level of p-p38 MAPK but did markedly reduce the protein levels of p-p44/42, compared with all the uric acid doses-treated VSMCs, especially at 1 h. Uric acid stimulation increased caspase-3 protein levels and decreased Bcl-xL, but did not alter caspase-8 protein expression at the same dose and time. Furthermore, low uric acid incubations (0-7.5 mg/dL) did not affect any signaling pathways for long time points (6-24 h). In conclusion, our study demonstrates for the first time that VSMCs induced with uric acid can affect cell viability, proliferative, and apoptosis pathways at the widest time and dose range. These findings provide a better understanding of the uric acid effects related to vascular impairments.
Collapse
Affiliation(s)
- Segün Doğru
- Department of Biochemistry, Medical School of Akdeniz University, Antalya, Turkey
| | - Ekrem Yaşar
- Department of Biophysics, Medical School of Akdeniz University, Antalya, Turkey
| | - Akın Yeşilkaya
- Department of Biochemistry, Medical School of Akdeniz University, Antalya, Turkey
| |
Collapse
|
5
|
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
|
6
|
Braga D, Garcia Rosa ML, Altenburg Gismondi R, Lugon JR, Torres K, Nalin B, Kang H, Alcoforado V, Martínez Cerón DM. Uric acid and salt intake as predictors of incident hypertension in a primary care setting. REVISTA COLOMBIANA DE CARDIOLOGÍA 2020. [DOI: 10.1016/j.rccar.2019.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
7
|
Lan Q, Wu H, Zhou X, Zheng L, Lin F, Meng Q, Xi X, Yue A, Buys N, Sun J, Liu Z, Li J, Fan H. Predictive Value of Uric Acid Regarding Cardiometabolic Disease in a Community-Dwelling Older Population in Shanghai: A Cohort Study. Front Med (Lausanne) 2020; 7:24. [PMID: 32118009 PMCID: PMC7025523 DOI: 10.3389/fmed.2020.00024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 01/16/2020] [Indexed: 11/24/2022] Open
Abstract
Aim: This study aimed to test the predictive power of serum uric acid (UA) levels on new-onset cardiometabolic risk in the Chinese population. Methods: Older people who visited a community health center for a yearly health check (N = 5,000; men: 47%, women: 53%) were enrolled. Participants were followed for 4 years from baseline (median: 48 months), with the endpoints being development of heart failure, atrial fibrillation, diabetes, hypertension, metabolic syndrome, or kidney disease. Results: During follow-up, 342 men (7.4%) and 360 women (8.6%) developed hypertension; 98 men (2.48%) and 135 women (3.06%) developed diabetes; and 175 men (5.04%) and 214 women (4.51%) developed metabolic syndrome. Incident diabetes, hypertension, and metabolic syndrome increased with increased UA levels at baseline (P < 0.001). A multivariate Cox proportional hazards analysis revealed a significant, independent association between the baseline UA level and the onset and future hypertension and/or diabetes in both men and women. However, UA is associated with the development of metabolic syndrome in men, but not in women. Conclusion: UA is an independent predictor of new-onset diabetes and hypertension in both women and men and a predictor of new-onset metabolic syndrome only in men.
Collapse
Affiliation(s)
- Qin Lan
- Shanghai East Hospital, Tongji University, Shanghai, China.,School of Medicine, Tongji University, Shanghai, China
| | - Hong Wu
- Gaohang Community Hospital, Pudong New Area, Shanghai, China
| | - Xiaohui Zhou
- Shanghai East Hospital, Tongji University, Shanghai, China.,School of Medicine, Tongji University, Shanghai, China
| | - Liang Zheng
- Shanghai East Hospital, Tongji University, Shanghai, China.,School of Medicine, Tongji University, Shanghai, China
| | - Fang Lin
- Shanghai East Hospital, Tongji University, Shanghai, China.,School of Medicine, Tongji University, Shanghai, China
| | - Qingshu Meng
- Shanghai East Hospital, Tongji University, Shanghai, China.,School of Medicine, Tongji University, Shanghai, China
| | - Xiaoling Xi
- Shanghai East Hospital, Tongji University, Shanghai, China.,School of Medicine, Tongji University, Shanghai, China
| | - Aixue Yue
- Shanghai East Hospital, Tongji University, Shanghai, China.,School of Medicine, Tongji University, Shanghai, China
| | - Nicholas Buys
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Jing Sun
- School of Medicine, Griffith University, Gold Coast, QLD, Australia
| | - Zhongmin Liu
- Shanghai East Hospital, Tongji University, Shanghai, China.,School of Medicine, Tongji University, Shanghai, China
| | - Jue Li
- School of Medicine, Tongji University, Shanghai, China
| | - Huimin Fan
- Shanghai East Hospital, Tongji University, Shanghai, China.,School of Medicine, Tongji University, Shanghai, China
| |
Collapse
|
8
|
Impact of uric acid on incident hypertension: Sex-specific analysis in different age groups. INTERNATIONAL JOURNAL CARDIOLOGY HYPERTENSION 2019; 2:100009. [PMID: 33447742 PMCID: PMC7803020 DOI: 10.1016/j.ijchy.2019.100009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 05/22/2019] [Indexed: 11/22/2022]
Abstract
The aim of the present study is to evaluate the association of serum uric acid (UA) levels with the risk of incident hypertension among different age groups in men and women using a single large Japanese general cohort. The present study is based on annual health check-up program in Gunma, Japan. We studied 12,029 participants (mean age, 48 ± 9 years old; 31% women) free of prevalent cardiovascular disease and hypertension at baseline (2009). Hypertension was defined by self-report, hypertensive medication use, or measured BP > 140/90 mmHg at each visit. Discrete proportional hazards regression model was used to evaluate the association of UA level at baseline with incident hypertension through 2012 adjusted for age, gender, baseline blood pressure, and other CVD risk factors among different age decade groups in men and women. During follow-up of 3 years, 12% of the cohort (n = 1457) developed hypertension. UA was strongly associated with incident hypertension in the multivariable model in all participants. In age-stratified analysis, participants below 50 years of age in men had the significant association of UA with incident hypertension, whereas participants above 50 years did not. In women, participants above 40 years had the significant association, whereas participants below 40 years did not. The present data suggest that UA level is an independent predictor for incident hypertension among middle aged men below 50 years old and middle aged and the elderly women above 40 years.
Collapse
|
9
|
Kawada T. Relationship between serum uric acid and blood pressure by adjusting dietary factors. J Clin Hypertens (Greenwich) 2018; 20:418. [PMID: 29370466 DOI: 10.1111/jch.13198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
| |
Collapse
|
10
|
Abstract
If hyperuricemia is an independent risk factor in blood-pressure control, urate-lowering therapy should be used to reduce cardiovascular risk. It may also act as a prognostic marker of other abnormalities. This review presents current evidence on the relationship between hyperuricemia and hypertension.
Collapse
Affiliation(s)
- Guido Grassi
- a Clinica Medica , University of Milano-Bicocca and IRCCS Multimedica , Sesto San Giovanni , Milan , Italy
| |
Collapse
|
11
|
Han GM, Liu P. Higher serum lycopene is associated with reduced prevalence of hypertension in overweight or obese adults. Eur J Integr Med 2017. [DOI: 10.1016/j.eujim.2017.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
12
|
Sun HL, Pei D, Lue KH, Chen YL. Uric Acid Levels Can Predict Metabolic Syndrome and Hypertension in Adolescents: A 10-Year Longitudinal Study. PLoS One 2015; 10:e0143786. [PMID: 26618358 PMCID: PMC4664290 DOI: 10.1371/journal.pone.0143786] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 11/08/2015] [Indexed: 02/07/2023] Open
Abstract
The relationships between uric acid and chronic disease risk factors such as metabolic syndrome, type 2 diabetes mellitus, and hypertension have been studied in adults. However, whether these relationships exist in adolescents is unknown. We randomly selected 8,005 subjects who were between 10 to 15 years old at baseline. Measurements of uric acid were used to predict the future occurrence of metabolic syndrome, hypertension, and type 2 diabetes. In total, 5,748 adolescents were enrolled and followed for a median of 7.2 years. Using cutoff points of uric acid for males and females (7.3 and 6.2 mg/dl, respectively), a high level of uric acid was either the second or third best predictor for hypertension in both genders (hazard ratio: 2.920 for males, 5.222 for females; p<0.05). However, uric acid levels failed to predict type 2 diabetes mellitus, and only predicted metabolic syndrome in males (hazard ratio: 1.658; p<0.05). The same results were found in multivariate adjusted analysis. In conclusion, a high level of uric acid indicated a higher likelihood of developing hypertension in both genders and metabolic syndrome in males after 10 years of follow-up. However, uric acid levels did not affect the occurrence of type 2 diabetes in both genders.
Collapse
Affiliation(s)
- Hai-Lun Sun
- Department of Pediatrics, Chung Shan Medical University Hospital, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- * E-mail: (HLS); (YLC)
| | - Dee Pei
- Department of Internal Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Ko-Huang Lue
- Department of Pediatrics, Chung Shan Medical University Hospital, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yen-Lin Chen
- Department of Pathology, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan
- * E-mail: (HLS); (YLC)
| |
Collapse
|
13
|
Liu P, Chen Y, Wang B, Zhang F, Wang D, Wang Y. Allopurinol treatment improves renal function in patients with type 2 diabetes and asymptomatic hyperuricemia: 3-year randomized parallel-controlled study. Clin Endocrinol (Oxf) 2015; 83:475-82. [PMID: 25400252 DOI: 10.1111/cen.12673] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Revised: 09/05/2014] [Accepted: 11/12/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To investigate the effects of long-term effective control of serum uric acid on renal function in patients with type 2 diabetes and asymptomatic hyperuricemia. METHODS Application of randomized open parallel-controlled methods, a total of 176 patients with type 2 diabetes and asymptomatic hyperuricemia were selected, and was randomly divided into two groups for allopurinol or conventional treatments, respectively. Changes in urinary albumin excretion rate (UAER), the levels of serum creatinine and glomerular filtration rate (GFR) and the incidence of new-onset diabetic nephropathy (DN) and hypertension in patients before and after 3 years of treatment were measured and compared between groups. RESULTS There were no statistically significant difference in the baseline clinical characteristics of study participants between two treatment groups (P > 0·05 for all). After 3 years of treatment, compared to the conventional treatment, the allopurinol treatment was more effective in reducing serum uric acid, UAER, serum creatinine (P < 0·01 for all) and increasing GFR (P < 0·01). The intention-to-treat (ITT) analysis indicated that the incidence of new-onset DN and hypertension in the allopurinol group showed a declining trend compared to that in the conventional treatment group, despite a lack of significant difference (P > 0·05). CONCLUSION Long-term effective control of serum uric acid can decrease UAER and serum creatinine, increase GFR and may exert kidney protection effects in patients with type 2 diabetes and asymptomatic hyperuricemia.
Collapse
Affiliation(s)
- Peng Liu
- Department of Endocrinology, Laiwu Hospital Affiliated to Taishan Medical College, Laiwu, China
| | - Yingying Chen
- Department of Endocrinology, Laiwu Hospital Affiliated to Taishan Medical College, Laiwu, China
| | - Bin Wang
- Department of Endocrinology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Fengmei Zhang
- Department of Endocrinology, Laiwu Hospital Affiliated to Taishan Medical College, Laiwu, China
| | - Debao Wang
- Department of Endocrinology, Laiwu Hospital Affiliated to Taishan Medical College, Laiwu, China
| | - Yangang Wang
- Department of Endocrinology, The Affiliated Hospital of Qingdao University, Qingdao, China
| |
Collapse
|
14
|
Liu P, Wang H, Zhang F, Chen Y, Wang D, Wang Y. The Effects of Allopurinol on the Carotid Intima-media Thickness in Patients with Type 2 Diabetes and Asymptomatic Hyperuricemia: A Three-year Randomized Parallel-controlled Study. Intern Med 2015; 54:2129-37. [PMID: 26328636 DOI: 10.2169/internalmedicine.54.4310] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the long-term effective control of serum uric acid by allopurinol on the carotid intima-media thickness (IMT) in patients with type 2 diabetes (T2DM) and asymptomatic hyperuricemia (HUA). METHODS This was a randomized open parallel-controlled study. In this study, 176 patients with T2DM and asymptomatic HUA were randomly allocated to the conventional or allopurinol treatment groups on the basis of a computer-generated random number table. Changes in the carotid IMT, biochemical indexes, high sensitive C-reactive protein (hs-CRP) and the incidence of hypertension in patients before and after three years of treatment were examined and compared between the groups. RESULTS There were no statistically significant differences in the baseline characteristics of the study participants between the two treatment groups (p>0.05 for all). Nevertheless, the serum uric acid, triglyceride, and hs-CRP levels and the homeostasis assessment for insulin resistance (HOMA-IR), systolic blood pressure, diastolic blood pressure and the carotid IMT in the allopurinol group were significantly lower than those in the conventional group after three years of treatment (p<0.01 for all). The intention-to-treat analysis indicated that the incidence of new-onset hypertension in the allopurinol group showed a declining trend compared to that in the conventional treatment group (6.8% vs. 13.6%, p>0.05). CONCLUSION The long-term effective control of serum uric acid by allopurinol may improve insulin resistance, decrease the serum levels of hs-CRP, reduce the carotid IMT, and may delay the development of atherosclerosis in patients with T2DM and asymptomatic HUA.
Collapse
Affiliation(s)
- Peng Liu
- Department of Endocrinology, The Affiliated Hospital of Qingdao University, China
| | | | | | | | | | | |
Collapse
|
15
|
Reynolds TM. Serum uric acid and new-onset hypertension: a possible therapeutic avenue? J Hum Hypertens 2014; 28:519-20. [DOI: 10.1038/jhh.2013.147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|