The problem of hyperuricemia in the hypertensive population of the Nizhny Novgorod region

Abstract

Objective. To assess the prevalence of hypertension (HTN) in the population of the Nizhny Novgorod region and its relationship with hyperuricemia (HU) and other cardiovascular risk factors. Design and methods. We examined 2501 people aged 35–74 in the population of the Nizhny Novgorod region, selected by the stratified multi-stage random sample. All respondents underwent a laboratory study of the following parameters: total cholesterol, low-density lipoproteins (LDL), high-density lipoproteins, triglycerides (TG), fasting glucose, creatinine, uric acid, highly sensitive C-reactive protein (Hs-CRP) and fibrinogen. We also calculated body mass index (BMI), visceral obesity index with Amato formula and glomerular filtration rate with CKD-EPI formula. Binary logistic regression method was used to construct a predictive model for the risk of HTN. Statistical analysis was performed with IBM SPSS Statistics 26 software (USA). Results. HU was identified in 29,3 % of respondents with HTN. The mean uric acid level in this group was 345,1 [285,6; 410,55] µmol/l and significantly differed from the same indicator in residents without HTN — 297,5 [249,9; 351,1] µmol/L (p < 0,001). In the multiple logistic regression model, the most significant factors associated with HTN were age over 53 years (odds ratio (OR) 2,954, 95 % confidence interval (CI) 2,456-3,554 p < 0,001), abdominal obesity (OR 2,112, 95 % CI 1,663-2,730, p < 0,001) and HU (OR 1,709, 95 % CI 1,341–2,177, p < 0,001). A lesser contribution was made by such factors as the respondents’ BMI over 25 kg/m2 (OR 1,634, 95 % CI 1,262–2,117, p < 0,001), elevated TG level (OR 1,567, 95 % CI 1,289–1,906, p < 0,001), male gender (OR 1,553, 95 % CI 1,281–1,883, p < 0,001), elevated Hs-CRP (OR 1,498, 95 % CI 1,242–1,806, p < 0,001), elevated LDL (OR 1,277, 95 % CI 1,038–1,570, p = 0,020). Conclusions. The results of the study indicate the widespread prevalence of HU in residents of the Nizhny Novgorod region with HTN: almost every third (29,3 %) had this disorder. In a multiple logistic regression model, HU was found to be highly correlated with HTN (OR 1,709, 95 % CI 1,341–2,177, p < 0,001), along with traditional cardiovascular risk factors such as male gender, age, overweight and obesity, lipid metabolism disorders. The high frequency of HU, its independent correlation with HTN, and the prospects for urate-lowering therapy in the prevention of cardiovascular diseases determine the need for further research.