High serum uric acid is associated with increased arterial stiffness in hypertension

An, Li-Na; Rong, Ning; Ning, Min; Feng, Lixia; Chen, Zhen-Han; Liu, Weiqing; Ouyang, Xiao-Chun; Diao, Feiyang; Han, Zhaohui; Hong, Jiang

doi:10.18632/aging.103506

Cited by 10 publications

(5 citation statements)

References 39 publications

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“…We found the significant positive correlation between the IMC thickness and the serum levels of UA, hsCRP, despite controversial previous data on this topic. Ramirez et al [11,12] reported an independent association between UA and the IMC thickness, while Songand et al [13,14] did not find such a correlation, which may be related to different characteristics of the sample and the methodological approaches chosen.…”

Section: Discussionmentioning

confidence: 96%

The state of carotid artery wall in hypertensive patients with gout based on the study of inflammatory markers

Кузьміна¹,

Lazarenko²

2021

ZMJ

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The aim. To analyze the frequency of atherosclerotic lesions of the carotid arteries and association with the lipid metabolism and inflammatory markers in hypertensive patients with gout. Materials and methods. 122 patients with hypertension aged 30 to 65 years were examined (mean age (56.0 (47.0; 62.0)), including 104 men (85.2 %) and 18 women (14.8 %). Group 1 included 72 hypertensive patients with gout; group 2 – 50 hypertensive patients without gout; group 3 – 20 gout patients without hypertension. Serum levels of high sensitivity C-reactive protein were detected by enzyme-linked immunosorbent assay. Serum ferritin levels were measured using electrochemiluminescent detection. The patients underwent carotid artery ultrasound according to standard methods. Results. The duration of gout exacerbation and the pain intensity evaluated with the visual analog scale (VAS) (P < 0.01) were significantly higher in group 1, than those in group 3 (P < 0.01). Serum ferritin levels were 2.6 (P < 0.01) times higher in group 1 than those in group 2. In patients with gout, the levels of ferritin were significantly 2.1 times higher, than in group 2 (P < 0.01). The levels of hsСRP in patients of group 1 were 3.1 times higher than those in group 2 (P < 0.01). The proportion of patients with intima-media complex (IMC) thickness ≥0.9 mm was higher in group 1 than in groups 2 (χ2 = 4.58, P < 0.05) and 3 (χ2 = 24.96, P < 0.01). In the structure of plaques, isoechoic were significantly more often seen among group 1 patients as compared to group 3 (χ2 = 6.56, P < 0.01), and hyperechoic – as compared to group 2 (χ2 = 4.63, P < 0.05). Hypoechoic plaques were detected in groups 1 and 2 with similar frequency (P > 0.05). This type of plaque was associated with a high risk of cerebrovascular events. In the patients with arterial hypertension and gout, a significant moderate positive correlation was found between the IMC thickness and the serum uric acid level (rs = 0.46, P < 0.01), hsCRP (rs = 0.33, P < 0.01), age (rs = 0.33; P < 0.01), duration of gout (rs = 0.27, P < 0.05) and VAS (rs = 0.39, P < 0.01); the level of hsCRP was correlated with the presence of atherosclerotic plaques (τ = +0.64, P < 0.05). Conclusions. The combination of hypertension with gout in patients was associated with a high incidence of IMC thickness ≥0.9 mm and atherosclerotic plaques, more severe disorders of purine and lipid metabolism, increased inflammatory markers (ferritin and hsCRP), that should be considered not only in the aspect of chronic inflammation, but also as a part of the disease.

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Section: Discussionmentioning

confidence: 96%

The state of carotid artery wall in hypertensive patients with gout based on the study of inflammatory markers

Кузьміна¹,

Lazarenko²

2021

ZMJ

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“…Of note, Hcy and UA are thought to mediate adverse cardiovascular events through arterial stiffness [ 16 , 40 ]. Previous population-based studies have shown that high Hcy or high UA is an independent risk factor of arterial stiffness [ 19 , 41 ]. However, studies on the effect of Hcy and UA on arterial stiffness are mostly limited to people with high risk of cardiovascular diseases, such as hypertension, diabetes, and metabolic syndrome.…”

Section: Discussionmentioning

confidence: 99%

Mutual effect of homocysteine and uric acid on arterial stiffness and cardiovascular risk in the context of predictive, preventive, and personalized medicine

Zhang

et al. 2022

EPMA Journal

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Background Arterial stiffness is a major risk factor and effective predictor of cardiovascular diseases and a common pathway of pathological vascular impairments. Homocysteine (Hcy) and uric acid (UA) own the shared metabolic pathways to affect vascular function. Serum uric acid (UA) has a great impact on arterial stiffness and cardiovascular risk, while the mutual effect with Hcy remains unknown yet. This study aimed to evaluate the mutual effect of serum Hcy and UA on arterial stiffness and 10-year cardiovascular risk in the general population. From the perspective of predictive, preventive, and personalized medicine (PPPM/3PM), we assumed that combined assessment of Hcy and UA provides a better tool for targeted prevention and personalized intervention of cardiovascular diseases via suppressing arterial stiffness. Methods This study consisted of 17,697 participants from Beijing Health Management Cohort, who underwent health examination between January 2012 and December 2019. Brachial-ankle pulse wave velocity (baPWV) was used as an index of arterial stiffness. Results Individuals with both high Hcy and UA had the highest baPWV, compared with those with low Hcy and low UA (β: 30.76, 95% CI: 18.36–43.16 in males; β: 53.53, 95% CI: 38.46–68.60 in females). In addition, these individuals owned the highest 10-year cardiovascular risk (OR: 1.49, 95% CI: 1.26–1.76 in males; OR: 7.61, 95% CI: 4.63–12.68 in females). Of note, males with high homocysteine and low uric acid were significantly associated with increased cardiovascular risk (OR: 1.30, 95% CI: 1.15–1.47), but not the high uric acid and low homocysteine group (OR: 1.02, 95% CI: 0.90–1.16). Conclusions This study found the significantly mutual effect of Hcy and UA on arterial stiffness and cardiovascular risk using a large population and suggested the clinical importance of combined evaluation and control of Hcy and UA for promoting cardiovascular health. The adverse effect of homocysteine on arteriosclerosis should be addressed beyond uric acid, especially for males. Monitoring of the level of both Hcy and UA provides a window opportunity for PPPM/3PM in the progression of arterial stiffness and prevention of CVD. Hcy provides a novel predictor beyond UA of cardiovascular health to identify individuals at high risk of arterial stiffness for the primary prevention and early treatment of CVD. In the progressive stage of arterial stiffness, active control of Hcy and UA levels from the aspects of dietary behavior and medication treatment is conducive to alleviating the level of arterial stiffness and reducing the risk of CVD. Further studies are needed to evaluate the clinical effect of Hcy and UA targeted intervention on arterial stiffness and cardiovascular health.

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“…Hypertensive patients with hyperuricemia also presented with higher CF-PWV than hypertensive patients without hyperuricemia [ 11 ]. In a large hypertensive population from China comprising 10,450 participants, of whom > 90% were receiving antihypertensive agents and ~ 50% were current smokers, serum uric acid was a risk factor for higher brachial-ankle PWV in men and women [ 38 ]. As a major difference to our study, medicated hypertensive subjects were included in the analyses of the above studies [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Plasma uric acid is related to large arterial stiffness but not to other hemodynamic variables: a study in 606 normotensive and never-medicated hypertensive subjects

Hamid

Kurra

Choudhary

et al. 2021

BMC Cardiovasc Disord

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Background Elevated level of plasma uric acid (PUA) has been associated with cardiovascular disease, but whether uric acid is an independent risk factor or merely a marker remains controversial. Methods We investigated in a cross-sectional setting the association of PUA with hemodynamics in 606 normotensive and never-medicated hypertensive subjects (295 men, 311 women, age range 19–73 years) without cardiovascular disease or gout. In all except 15 individuals, PUA was within the normal range. Supine hemodynamics were recorded using whole-body impedance cardiography and radial tonometric pulse wave analysis. Results The mean concentrations of PUA in age, sex and body mass index adjusted quartiles were 234, 278, 314, and 373 µmol/l, respectively. The highest PUA quartile presented with higher aortic to popliteal pulse wave velocity (PWV) than the lowest quartile (8.7 vs. 8.2 m/s, p = 0.026) in analyses additionally adjusted for plasma concentrations of C-reactive protein, low density lipoprotein cholesterol, triglycerides, and mean aortic blood pressure. No differences in radial and aortic blood pressure, wave reflections, heart rate, cardiac output, and systemic vascular resistance were observed between the quartiles. In linear regression analysis, PUA was an independent explanatory factor for PWV (β = 0.168, p < 0.001, R2 of the model 0.591), but not for systolic or diastolic blood pressure. When the regression analysis was performed separately for men and women, PUA was an independent predictor of PWV in both sexes. Conclusions PUA concentration was independently and directly associated with large arterial stiffness in individuals without cardiovascular disease and PUA levels predominantly within the normal range. Trial registration ClinicalTrials.gov NCT01742702.

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High serum uric acid is associated with increased arterial stiffness in hypertension

Cited by 10 publications

References 39 publications

The state of carotid artery wall in hypertensive patients with gout based on the study of inflammatory markers

The state of carotid artery wall in hypertensive patients with gout based on the study of inflammatory markers

Mutual effect of homocysteine and uric acid on arterial stiffness and cardiovascular risk in the context of predictive, preventive, and personalized medicine

Plasma uric acid is related to large arterial stiffness but not to other hemodynamic variables: a study in 606 normotensive and never-medicated hypertensive subjects

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