Sex‐related relationships between uric acid and target organ damage in hypertension

Abstract

Heterogeneous results have been obtained in the relationship between serum uric acid (SUA) and target organ damage (TOD) in patients with hypertension. Clinic blood pressure, SUA, and cardiac, arterial (carotid and aortic), and renal TOD were assessed in 762 consecutive patients with hypertension. Hyperuricemia was defined as an SUA >7.0 in men and >6.0 mg/dL in women. Men with hyperuricemia compared with those with normal SUA showed lower estimated glomerular filtration rates and E/A ratios and a higher prevalence of carotid plaques. Women with hyperuricemia showed lower estimated glomerular filtration rates and E/A ratios and a higher intima-media thickness. Except for pulse wave velocity, all TODs significantly correlated with SUA.However, at multivariate analysis, only estimated glomerular filtration rate was significantly determined by SUA. Our data provide evidence on the role of SUA in the development of TOD only in the case of renal alteration. It is likely that SUA may indirectly act on the other TODs through the increase in blood pressure and the decrease in glomerular filtration rate. | INTRODUCTIONHyperuricemia is frequently detected in patients with essential hypertension, in which serum uric acid (SUA) levels have been related to the development of elevated blood pressure (BP) values as well as to the occurrence of cardiovascular and renal events. 6-10In the present study, we sought to assess the role of SUA in determining multiple TOD in patients with treated hypertension by overcoming the limitations of the previously published studies. We thus conducted the analysis of SUA data related to the vascular, endothelial, metabolic, cardiac, and renal targets in a population of patients with treated hypertension as a whole, and as classified in subgroups according to sex. | METHODS | Study populationWe enrolled 762 consecutive outpatients between the ages of 18 and 80 years, who had essential hypertension and were followed by the hypertension unit of the San Gerardo Hospital (Monza, Italy).

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“…UA has been also identified as a potential factor concurring in the development and/or progression of preclinical TOD. Regarding arterial stiffness, this association has been evaluated in numerous cross‐sectional studies; however, these studies frequently provided heterogeneous results . Furthermore, to the best of our knowledge, only three published paper have evaluated the relationship between UA and PWV in prospective cohort …”