Uric Acid and Hypertension: Prognostic Role and Guide for Treatment

Piani, Federica; Cicero, Arrigo F G; Borghi, Claudio

doi:10.3390/jcm10030448

Cited by 43 publications

(35 citation statements)

References 115 publications

(230 reference statements)

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“…In our study, the incidence of cardiovascular comorbidities, including hypertension, dyslipidemia, ischemic heart disease, and stroke, were significantly increased among patients with gout compared to the control group. These results were consistent with previous studies [19][20][21][22].…”

Section: Discussionsupporting

confidence: 94%

Clinical Association between Gout and Parkinson’s Disease: A Nationwide Population-Based Cohort Study in Korea

et al. 2021

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Background and Objectives: This retrospective cohort study aimed to investigate the association between gout and Parkinson’s disease (PD) in Korea. Materials and Methods: Overall, 327,160 patients with gout and 327,160 age- and sex-matched controls were selected from the Korean National Health Insurance Service (NHIS) database. PD incidence was evaluated by reviewing NHIS records during the period from 2002 to 2019. Patients with a diagnosis of gout (International Classification of Diseases-10 (ICD-10), M10) who were prescribed medications for gout, including colchicine, allopurinol, febuxostat, and benzbromarone for at least 90 days were selected. Patients with PD who were assigned a diagnosis code (ICD-G20) and were registered in the rare incurable diseases (RID) system were extracted. Results: During follow-up, 912 patients with gout and 929 control participants developed PD. The incidence rate (IR) of overall PD (per 1000 person-years) was not significantly different between both groups (0.35 vs. 0.36 in gout and control groups, respectively). The incidence rate ratio (IRR) was 0.98 (95% CI: 0.89–1.07). The cumulative incidence of PD was not significantly different between the groups. No association between gout and PD was identified in univariate analysis (HR = 1.00, 95% CI: 0.91–1.10, p = 0.935). HR increased significantly with old age (HR = 92.08, 198, and 235.2 for 60–69 years, 70–79 years, and over 80 years, respectively), female sex (HR = 1.21, 95% CI: 1.07–1.37, p = 0.002), stroke (HR = 1.95, 95% CI: 1.76–2.16, p < 0.001), and hypertension (HR = 1.16, 95% CI: 1.01–1.34, p = 0.04). Dyslipidemia exhibited an inverse result for PD (HR = 0.6, 95% CI: 0.52–0.68, p < 0.001). Conclusions: This population-based study did not identify an association between gout and PD. Age, female sex, stroke, and hypertension were identified as independent risk factors for PD, and dyslipidemia demonstrated an inverse result for PD.

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Section: Discussionsupporting

confidence: 94%

Clinical Association between Gout and Parkinson’s Disease: A Nationwide Population-Based Cohort Study in Korea

et al. 2021

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“…Variations of these genes in the form of risk alleles favor a higher rate of hyperuricemia and occur more frequently in Chinese, Japanese, Africans in Southwest USA, and Mexicans compared to Europeans [16]. Mendelian randomization studies demonstrate a correlation between xanthine oxidase (XO) genetic polymorphisms and SUA levels and a causal effect of SUA on the progression of related diseases [15,17]. Some scientific reports suggest that SUA may also be dependent on estrogen levels which down-regulate ABCG2 and SLC2A9 genes leading to decreased renal UA reabsorption [18].…”

Section: Introductionmentioning

confidence: 99%

Serum Uric Acid Is a Weak Independent Predictor of Overall Survival in Older Adults

Winder

Owczarek

Mossakowska

et al. 2021

JCM

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Hyperuricemia accompanies many pathologies that contribute to overall death rate. The population-based multifaceted study of older adults in Poland made it possible to assess the effect of serum uric acid (SUA) on overall mortality. The PolSenior study performed between 2007–2011 included 3926 participants aged 65 years or above (mean age 79 ± 9 years) not treated with xanthin oxidase inhibitors (XOI) who were stratified by sex and SUA concentration into six subgroups increasing by 1 mg/dL. In 2019, survival data were retrieved from the population register. The crude risk of death was significantly higher in men and women with SUA ≥ 7 mg/dL. After adjustment to statistically significant factors, SUA remained a risk factor of death in men with SUA ≥ 8 mg/dL only, potentially due to the limited number of women with high SUA levels. Furthermore, age, heart failure, diabetes, and activities of daily living ≤ 4 pts were identified as factors increasing mortality risk regardless of sex. The risk of death increased also with smoking, past stroke, COPD/asthma, and hs-CRP > 3 mg/dL for men; and eGFR < 45 mL/min/1.73 m2, mini nutritional assessment ≤ 7 pts, and loop diuretics use for women. Mild hyperuricemia is a significant health status marker and an independent risk factor for overall mortality in older Caucasians not receiving XOI. Increased mortality is mostly limited to subjects with SUA levels ≥ 8 mg/dL.

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“… 34 , 35 Possible mechanisms linking SUA levels and hypertension involve the activation of renin‐angiotensine‐aldosterone system, the promotion of a pro‐oxidant and proinflammatory state, a direct damage of the kidney afferent arteriola and the development of endothelial dysfunction. 36 …”

Section: Discussionmentioning

confidence: 99%

Association Between Uric Acid, Carotid Intima‐Media Thickness, and Cardiovascular Events: Prospective Results From the IMPROVE Study

Mannarino

Pirro

Gigante³

et al. 2021

JAHA

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Background The association between elevated serum uric acid (SUA), cardiovascular disease (CVD) risk, and carotid atherosclerosis has long been explored, and contrasting results have been reported. Therefore, the role of SUA as an independent risk factor for vascular events (VEs) and carotid atherosclerosis deserves further attention. We investigated the relationship between SUA, incident VEs, carotid intima‐media thickness (cIMT), and cIMT progression in subjects at moderate‐to‐high CVD risk. Methods and Results In the IMPROVE (IMT‐Progression as Predictors of VEs) study, 3686 participants (median age 64 years; 48% men) with ≥ 3 vascular risk factors, free from VEs at baseline, were grouped according to SUA quartiles (division points: 244–284–328 µmol/L in women, 295–336–385 µmol/L in men). Carotid‐IMT and its 15‐month progression, along with incident VEs, were recorded. A U‐shaped association between SUA and VEs was observed in men, with 2.4‐fold ( P = 0.004) and 2.5‐fold ( P = 0.002) increased CVD risk in the first and fourth SUA quartiles as compared with the second. Adjusted hazard ratios (HRs) for cerebro‐VEs in men were the highest (first and fourth quartile versus second: HR, 5.3, P = 0.010 and HR, 4.4, P = 0.023, respectively). SUA level was independently associated with cIMT progression in men (β = 0.068, P = 0.014). No significant association between SUA levels, CVD end points, and cIMT progression were found in women. Conclusions Both low and high SUA levels are associated with an increased risk of VEs in men at moderate‐to‐high CVD risk but not in women. Only elevated SUA levels predict cIMT progression and at a lesser but not significant extent in women.

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Uric Acid and Hypertension: Prognostic Role and Guide for Treatment

Cited by 43 publications

References 115 publications

Clinical Association between Gout and Parkinson’s Disease: A Nationwide Population-Based Cohort Study in Korea

Clinical Association between Gout and Parkinson’s Disease: A Nationwide Population-Based Cohort Study in Korea

Serum Uric Acid Is a Weak Independent Predictor of Overall Survival in Older Adults

Association Between Uric Acid, Carotid Intima‐Media Thickness, and Cardiovascular Events: Prospective Results From the IMPROVE Study

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