Relationship Between Change in Serum Uric Acid and Ischemic Stroke in Chinese Hypertensive Patients

Abstract

Background: Limited studies focused on the association between serum uric acid (SUA) change with ischemic stroke, and their results remain controversial. The present study aimed to investigate the relationship between change in SUA with ischemic stroke among hypertensive patients.Method: This was a retrospective cohort study. We recruited adult hypertensive patients who had two consecutive measurements of SUA levels from 2013 to 2014 and reported no history of stroke. Change in SUA was assessed as SUA concentration measured in 2014 minus SUA concentration in 2013. Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). The Kaplan–Meier analysis and log-rank test were performed to quantify the difference in cumulative event rate. Additionally, subgroup analysis and interaction tests were conducted to investigate heterogeneity.Results: A total of 4,628 hypertensive patients were included, and 93 cases of ischemic stroke occurred during the mean follow-up time of 3.14 years. Participants were categorized into three groups according to their SUA change tertiles [low (SUA decrease substantially): <-32.6 μmol/L; middle (SUA stable): ≥-32.6 μmol/L, <40.2 μmol/L; high (SUA increase substantially): ≥40.2 μmol/L]. In the fully adjusted model, setting the SUA stable group as reference, participants in the SUA increase substantially group had a significantly elevated risk of ischemic stroke [HR (95% CI), 1.76 (1.01, 3.06), P = 0.0451], but for the SUA decrease substantially group, the hazard effect was insignificant [HR (95% CI), 1.31 (0.75, 2.28), P = 0.3353]. Age played an interactive role in the relationship between SUA change and ischemic stroke. Younger participants (age < 65 years) tended to have a higher risk of ischemic stroke when SUA increase substantially.Conclusion: SUA increase substantially was significantly correlated with an elevated risk of ischemic stroke among patients with hypertension.

Cumulative Serum Uric Acid Exposure and Its Time Course With the Risk of Incident Stroke

“…Several studies investigated the effect of changes in SUA on the risk of stroke, 26,27 while changes in SUA were evaluated based on 2 measurements of SUA and were unable to account for both the exposure intensity and duration of SUA over time. Our study filled the knowledge gap by demonstrating the dependence of stroke risk, not just on the present SUA level but also SUA versus time course, and offer a model to quantify the modulation of the risk by the time course of cumSUA accumulation.…”

The Association between Uric Acid Level and Ischemic Stroke

“…Researchers also observed the association between uric acid and ischemic stroke among patients with other medical conditions, such as hypertension or diabetes. A study with patients having hypertension showed that a significant increase in their uric acid was associated with a considerable increase in the risk of ischemic stroke, while a substantial decrease in uric acid levels was also associated with an increased risk of ischemic stroke, though the risk of stroke was not significant [19].…”

Uric Acid as a Risk Factor for Cardiovascular Diseases

“…Целью исследования Q. Tan и соавт. было изучить связь между изменением уровня МК и ишемическим инсультом у пациентов с АГ (n=4628) [44]. За время наблюдения (более 3 лет) зарегистрировано 93 случая ишемического инсульта.…”

“…За время наблюдения (более 3 лет) зарегистрировано 93 случая ишемического инсульта. Значительное увеличение МК значимо коррелировало с повышенным риском ишемического инсульта среди пациентов с АГ [44].…”