Hyperuricemia and Cardiovascular Risk

Shahin, Lauren; Patel, Komal; Heydari, Milad; Kesselman, Marc M

doi:10.7759/cureus.14855

Cited by 26 publications

(20 citation statements)

References 44 publications

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“…A cross-sectional study using CHNS data showed that the intake of purinerich food (not including vegetables) is associated with increased risk of hyperuricemia [12]. Similar findings have been reported in other countries or regions [8,10,[29][30][31][32]. We found that the inverse association with mortality was mainly in plant-derived purines, which is consistent with previous research on plant-derived purine-rich foods.…”

Section: Discussionsupporting

confidence: 91%

The Association between Dietary Purine Intake and Mortality: Evidence from the CHNS Cohort Study

Yan¹,

Liu²,

Wu³

et al. 2022

Nutrients

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Objectives: To investigate the association between dietary purine intake and mortality among Chinese adults. Methods: Based on data from the 2004–2015 China Health and Nutrition Survey (CHNS) and the corresponding edition of China Food Composition, the average purine intake per day (mg/day) from 2004 to 2011 was calculated, and the surveyed population was divided into five groups by quintiles. The outcome event and timepoint of concern were defined as death and time, respectively, as reported by family members, recorded until the 2015 survey. Cox proportional hazards regression was used to estimate the hazard ratios (HRs) with 95% confidence intervals (CIs) for death. The possibly nonlinear relationship between purine intake and mortality was examined with restricted cubic splines. Results: We included 17,755 subjects, and the average purine intake among them was 355.07 ± 145.32 mg/day. Purine intake was inversely associated with mortality (Ptrend < 0.001). Compared with the lowest quintiles of purine intake, the highest quintiles (HR = 0.60; 95% CI: 0.46, 0.77) showed a significant association with lower mortality. The negative association with mortality was mainly found in plant-derived purine (Ptrend = 0.001) and, weakly, in animal-derived purine (Ptrend = 0.052). In addition, a U-shaped relationship between purine intake and mortality was observed in males; however, there was no statistically significant dose–response relationship in females. Conclusion: Considering the low-purine-intake levels of the Chinese population, we observed a U-shaped relationship between purine intake and mortality in males, but purine intake may not relate to mortality in females. Future studies should investigate the causal relationship between purine intake and disease burden in China.

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Section: Discussionsupporting

confidence: 91%

The Association between Dietary Purine Intake and Mortality: Evidence from the CHNS Cohort Study

Yan¹,

Liu²,

Wu³

et al. 2022

Nutrients

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“…Control of risk factors in the secondary prevention of ASCVD could reduce the risk of cardiovascular events ( 13 ). Elevated SUA was reported to play roles in the development in ASCVD and multiple cardiovascular risk factors ( 6 , 14 ). In addition, several clinical investigations showed increased SUA might be a predictive marker for cardiovascular outcomes ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported hyperuricemia was associated with increased risk of cardiovascular events. Evidence also suggested elevated SUA has relations with traditional cardiovascular risk factors such as hypertension, insulin resistance, obesity, and hyperlipidemia ( 6 ). However, the association between SUA and CVD and established cardiovascular risk factors are controversial.…”

Section: Introductionmentioning

confidence: 99%

Association Between Serum Uric Acid Levels and Traditional Cardiovascular Risk Factors in Xiamen Residents of China: A Real-World Study

Zhang

Chen

et al. 2022

Front. Cardiovasc. Med.

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BackgroundSerum uric acid (SUA) levels was associated with cardiovascular diseases and cardiovascular events. However, the relationship between SUA levels and traditional cardiovascular risk factors has not been well-established among Xiamen residents. Our study aimed to estimate the relationship between SUA levels and cardiovascular risk factors among Xiamen residents using real-world data.MethodsParticipants were enrolled from eight community health service centers in Xiamen, China. Participants were divided into four groups according to quartiles of the SUA levels. The history of diseases, the use of medications and the levels of laboratory parameters were collected. The China-PAR equation was used to evaluate the 10-year atherosclerotic cardiovascular disease (ASCVD) risk.ResultsA total of 1,322 participants were enrolled. About 568 (43.0%) were men and 754 (57.0%) were women. The prevalences of hypertension, elderly, current smokers, and obesity were higher in the quartile 4 (Q4) group than the quartile 1 (Q1) group (all p < 0.001). Multivariable logistic regression analysis showed the OR for hypertension was 2.671 (95% CI 1.777–4.015, p < 0.001) in the Q4 group compared with that in the Q1 group. Further logistic regression showed the OR for hypertension was 3.254 (95% CI 1.756–6.031, p < 0.001) in men and 2.314 (95% CI 1.354–3.955, p = 0.002) in women in the Q4 group compared with that in the Q1 group, respectively. In addition, the percentage of participants with low 10-year ASCVD risk calculated by China-PAR was higher in the Q1 group than that in the Q4 group (55.86 vs. 31.82%, p < 0.001). The percentage of participants with high 10-year ASCVD risk was lower in the Q1 group compared with the Q4 group (15.32 vs. 25.45%, p < 0.001). Multiple linear logistic regression showed the 10-year China-PAR ASCVD risk scores was positively correlated with SUA after adjusting for various factors (β = 0.135, p = 0.001).ConclusionSerum uric acid was associated with several cardiovascular risk factors in Xiamen residents. The percentage of high 10-year ASDVD risk was higher in participants with hyperuricemia. Participants with hyperuricemia may experience cardiovascular benefit from uric acid-lowering therapy.

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“…Factors that also place patients at a high risk for periodontal disease may also place them at a high risk for systemic diseases, such as cardiovascular disease. Early detection and effective treatment for periodontal infections are critical in reducing bacteremia and preventing cases of IE [27].…”

Section: Diagnostics and Managementmentioning

confidence: 99%

A Review of Cardiac Manifestations in Patients With Systemic Lupus Erythematosus and Antiphospholipid Syndrome With Focus on Endocarditis

Tayem¹,

Shahin²,

Shook³

et al. 2022

Cureus

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Patients with autoimmune diseases such as systemic lupus erythematosus (SLE) or antiphospholipid syndrome (APS) are at a higher risk for adverse cardiovascular events associated with increased morbidity and mortality. The increased risk of these events is often associated with rheumatic heart disease (heart valve or mural endocardium damage from rheumatic fever) following microbial infection (i.e., untreated or under-treated streptococcal infection). In particular, the weakening of cardiac vasculature due to rheumatic heart disease makes such patients with autoimmune diseases more susceptible to endocarditis. Endocarditis can be caused by an infection (infective endocarditis) or inflammation tied to disease activity (non-bacterial thrombotic endocarditis [NBTE]). Infective endocarditis among patients with autoimmune diseases may result from exposure to pathogens during dental or surgical procedures. NBTE commonly occurs as a result of fibrin and platelet aggregation on the cardiac valves without bacterial infection. While diagnosis and management can vary based on underlying etiology, an interdisciplinary approach that includes prevention and management from dentists, cardiologists, rheumatologists, and primary care physicians is needed. In addition, increasing patient and physician education on risk factors and prevention strategies is much needed. This manuscript will review the pathophysiology of endocarditis, the association between SLE and APS and endocarditis risk, the diagnosis and management of these autoimmune diseases with a focus on the prevention of cardiovascular disease risk, and make recommendations for diagnostic and management approaches to improve care.

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Hyperuricemia and Cardiovascular Risk

Cited by 26 publications

References 44 publications

The Association between Dietary Purine Intake and Mortality: Evidence from the CHNS Cohort Study

The Association between Dietary Purine Intake and Mortality: Evidence from the CHNS Cohort Study

Association Between Serum Uric Acid Levels and Traditional Cardiovascular Risk Factors in Xiamen Residents of China: A Real-World Study

A Review of Cardiac Manifestations in Patients With Systemic Lupus Erythematosus and Antiphospholipid Syndrome With Focus on Endocarditis

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