Plasma Uric Acid and Hypertension in a Chinese Community: Prospective Study and Metaanalysis

Abstract

BACKGROUND: Hyperuricemia has been positively associated with hypertension, but whether this association is independent of adiposity and other cardiovascular risk factors remains a matter of debate.

Gender-Specific Relationship Between Serum Uric Acid Level and Atrial Fibrillation Prevalence

“…40 The present results also suggest that uric acid has genderspecific, independent effects on AF prevalence in women, because the association remained even after adjustment for comorbidities in women, but not in men. Interestingly, several previous studies have noted that the relative risks or OR for serum uric acid regarding development of hypertension 35 or renal disease, 36-38 were remarkably higher in women than in men, which was very similar to the present results. Although several studies have noted that the mechanism for the gender difference might be, at least in part, linked to menopause, it remains a matter for further discussion.…”

“…Recent studies have indicated that uric acid has a direct effect on smooth muscle cell proliferation, 31 endothelial dysfunction and decreased nitric oxide production, 32,33 as well as local activation of the RAS. 34 Consequently, these uric acid-associated pathogens would lead to the promotion or exacerbation of various comorbidities, including hypertension 35 and chronic kidney disease, 36-38 and the adverse effects of uric acid on these comorbidities might indirectly increase the potential risks for AF development. Another possible explanation would be direct mechanisms via inflammation.…”

Impact of different adiposity measures on the relation between serum uric acid and blood pressure in young adults

“…This is consistent with previous studies: Zhang et al 37 observed that the association between hyperuricemia and hypertension was partly mediated by WC and Bonora et al 49 found a marked attenuation in the correlations between uric acid and Cardiovascular disease risk factors upon adjustment for BMI. Although the direction of causality between SUA and adiposity is unclear, it is well known that SUA is highly correlated with obesity and other metabolic abnormalities, including insulin resistance.…”

“…Other studies have also found a stronger association between SUA and BP in females than in males. 36,37 Furthermore, a recent metaanalysis showed hyperuricemia to increase coronary heart disease mortality in women but not in men. 38 There is no agreement in the literature about the reasons for a sex difference in these relationships.…”

Review of Hyperuricaemia and Hypertension: A Target for Treatment

“…When included with 7 other studies in the meta-analysis (total 28,657 participants) there was a pooled relative risk of 1.55 for development of hypertension in those with the highest quartiles of serum urate. In Zhang's original study the association between hyperuricaemia and hypertension appeared to be partly mediated by abdominal obesity and it was postulated that this was due to hyperinsulinaemia enhancing uric acid reabsorption [25]. In 2011 Grayson conducted a meta-analysis of 18 published, prospective cohort studies (including the 8 studies used by Zhang) comprising a total of 55,607 patients (Table 1) [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42].…”