The Role of Uric Acid in Hypertension of Adolescents, Prehypertension and Salt Sensitivity of Blood Pressure

Wang, Yang; Hu, Jiawen; Lv, Yong-Bo; Chu, Chao; Wang, Keke; Zheng, Wenfang; Cao, Yumeng; Yuan, Zuyi; Mu, Jianjun

doi:10.12659/msm.899563

Cited by 33 publications

(18 citation statements)

References 62 publications

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“…The association between uric acid levels and damage accrual in patients with SLE was evaluated, and serum uric acid level was found to be associated with the development of new damage in these patients. Previous studies have found an association between hyperuricaemia and hypertension,13 metabolic syndrome14 and renal disease,2 as well as with organ failure or damage,15 especially renal 16…”

Section: Discussionmentioning

confidence: 99%

Serum uric acid is associated with damage in patients with systemic lupus erythematosus

et al. 2020

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IntroductionSerum uric acid levels have been reported as predictors of cardiovascular, pulmonary, neurological and renal morbidity in patients with SLE. However, their role in cumulative global damage in these patients has not yet been determined.ObjectiveTo determine whether serum uric acid levels are associated with new damage in patients with SLE.MethodsThis is a longitudinal study of patients with SLE from the Almenara Lupus Cohort, which began in 2012. At each visit, demographic and clinical characteristics were evaluated, such as activity (Systemic Lupus Erythematosus Disease Activity Index-2K or SLEDAI-2K) and cumulative damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index or SDI). Treatment (glucocorticoids, immunosuppressive drugs and antimalarials) was also recorded. Univariable and multivariable Cox regression models were used to determine the impact of serum uric acid levels on the risk of new damage.ResultsWe evaluated 237 patients, with a mean age (SD) at diagnosis of 35.9 (13.1) years; 220 patients (92.8%) were women, and the duration of the disease was 7.3 (6.6) years. The mean SLEDAI-2K and SDI scores were 5.1 (4.2) and 0.9 (1.3), respectively. Serum uric acid level was 4.5 (1.4) mg/dL. Follow-up time was 3.1 (1.3) years, and 112 (47.3%) patients accrued damage during follow-up. In univariable and multivariable analyses, serum uric acid levels were associated with new damage (HR=1.141 (95% CI 1.016 to 1.282), p=0.026; HR=1.189 (95% CI 1.025 to 1.378), p=0.022, respectively).ConclusionHigher serum uric acid levels are associated with global damage in patients with SLE.

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Section: Discussionmentioning

confidence: 99%

Serum uric acid is associated with damage in patients with systemic lupus erythematosus

et al. 2020

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“…Furthermore, in non-pregnant individuals, uric acid is known to be related to severity of cardiovascular disease and may be involved in the transition from pre-hypertension to hypertension even though the pathophysiology is not yet elucidated. 26,27 Therefore, salivary uric acid might not only reflect placental pathology but also maternal cardiovascular dysfunction.…”

Section: Ta B L E 3 Levels Of Salivary Uric Acidmentioning

confidence: 99%

Salivary uric acid as a predictive test of preeclampsia, pregnancy‐induced hypertension and preterm delivery: A pilot study

Püschl

Bonde

Reading

et al. 2020

Acta Obstet Gynecol Scand

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Introduction There remains a need for a non‐invasive, low‐cost and easily accessible way of identifying women at risk of developing hypertensive disorders in pregnancy. This study evaluated the predictive value of longitudinal salivary uric acid measurement. Material and methods Pregnant women (n = 137) from 20 weeks of gestation were recruited at St Richards Hospital, Chichester, UK, for this prospective cohort study. Weekly samples of salivary uric acid were analyzed until delivery. Information regarding pregnancy and labor were obtained from the patient’s record after delivery. Independent t tests were used to compare mean levels of salivary uric acid in women with hypertensive complications and adverse fetal outcomes with women with normal pregnancies. Main outcome measures were preeclampsia, pregnancy‐induced hypertension, spontaneous preterm delivery and small‐for‐gestational‐age babies. Results From 21 weeks of gestation until delivery, levels of salivary uric acid increased significantly in women who subsequently developed preeclampsia and pregnancy‐induced hypertension compared with women with normal pregnancies (preeclampsia—mean at gestational age 21‐24, 95% confidence interval [95% CI] [mean GA21‐24): 108 [63‐185] vs 47 (39‐55) µmol/L; P = .005; pregnancy‐induced hypertension—mean GA21‐24: 118 [54–258] vs 47 [39‐55] µmol/L; P = .004). In women who had spontaneous preterm delivery, salivary uric acid levels increased significantly from 29 to 32 weeks of gestation compared with women with normal pregnancies (mean GA29‐32: 112 (57‐221) vs 59 (50‐71) µmol/L; P = .04). In women who had babies small‐for‐gestational‐age <10th percentile and small‐for‐gestational‐age <3rd percentile, differences in salivary uric acid levels were insignificant. Conclusions Elevated levels of salivary uric acid precede the onset of preeclampsia, pregnancy‐induced hypertension and preterm delivery. Salivary uric acid may prove to be an early biomarker of hypertensive complications of pregnancy and spontaneous preterm delivery.

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“…The ultimate effect is reduced compliance of renal afferent arterioles, shifted pressure natriuresis curve, and sodium-sensitive hypertension. This level cannot be modified by SUA lowering agents [12][13][14][15]. A hypertensive effect of uric acid has been described in rats; however, it seems to be transferable to humans.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is possible that uric acid promotes hypertension regardless of other known risk factors, and its lowering may be beneficial as the only intervention. SUA was initially associated with essential hypertension as well as with prehypertension, especially in the overweight/obese [12,18]. The predictive value of increased uric acid is not limited to hypertension, but it refers also to cardiovascular disease, obesity, and metabolic syndrome.…”

Section: Discussionmentioning

confidence: 99%

Serum uric acid in HIV infected children and correlation to cardiovascular risk factors

Stańska-Perka¹,

Marczyńska²,

Zawadka³

et al. 2019

HIV & AIDS Review

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Introduction: Serum uric acid (SUA) has been reported to be associated with hypertension and metabolic syndrome. Metabolic disorders leading to increased cardiovascular risk are often observed in human immunodeficiency virus (HIV)-infected children. The aim of the study was to assess the level of SUA and its association with metabolic abnormalities and high blood pressure. Material and methods: Fasting SUA, total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), insulin, and glucose measurements were performed in 54 HIV-infected children (mean age 12.3 years), 46% male. All but two were treated with highly active antiretroviral therapy (HAART). HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) was calculated using the formula HOMA-IR = (insulin [mU/l] × glucose [mmol/l])/22.5. All children underwent anthropometric measurements. Body mass index (BMI) was calculated by dividing weight in kilograms by square of height in metres. Results: Mean SUA was 239.8 μmol/l, and no patient showed hiperuricaemia. SUA was higher in boys and in older children. Nadir immunologic category 3 was associated with higher SUA compared to category 1 and 2 together. Children with abnormal triglycerides, HDL-C, insulin, and HOMA-IR had significantly higher SUA. Regression analysis showed that all metabolic parameters apart from HDL-C influence SUA. Children treated with HAART based on non-nucleoside reverse transcriptase inhibitors (NNRTIs) had lower SUA in contrast to children receiving a protease inhibitor (PI)-based or other HAART scheme. We did not observe any association between SUA and high blood pressure. Conclusions: We showed correlation between SUA and metabolic parameters in HIV-infected children. Metabolic abnormalities are the result of both HIV infection and antiretroviral treatment. Association of SUA with CD4 nadir and HAART may indicate the effect of HIV itself or its treatment.

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The Role of Uric Acid in Hypertension of Adolescents, Prehypertension and Salt Sensitivity of Blood Pressure

Cited by 33 publications

References 62 publications

Serum uric acid is associated with damage in patients with systemic lupus erythematosus

Serum uric acid is associated with damage in patients with systemic lupus erythematosus

Salivary uric acid as a predictive test of preeclampsia, pregnancy‐induced hypertension and preterm delivery: A pilot study

Serum uric acid in HIV infected children and correlation to cardiovascular risk factors

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