Higher baseline uric acid concentration is associated with non-attainment of optimal blood pressure

Abstract

A significant relationship exists between elevated uric acid concentration and both prevalent and incident hypertension; however, data regarding the influence of higher uric acid concentration at baseline on blood pressure control by antihypertensive drugs is scarce. Thus, a prospective cohort study was performed. The study outcome was the non-attainment of optimal blood pressure (NOBP). NOBP level was defined according to the Japanese hypertension guideline. This study enrolled a Japanese community-based cohort (N = 8,664; age 65.5 ± 6.4 years; women, 55.0%) who were not using antihypertensive drugs on the first visit for a health checkup program but started using antihypertensive drug(s) on the next-year visit. The participants were classified into quartiles based basic uric acid concentration. Odds ratios (ORs) were calculated for NOBP as the primary outcome measure. Multivariable logistic analysis showed that quartile 4 was significantly associated with NOBP when quartile 1 was set as the reference (OR (95% confidence interval), 1.36 (1.16-1.59), p<0.01), adjusted for potential confounders, such as age, sex, body mass index, presence of diabetes/dyslipidemia/chronic kidney disease (CKD), history of cardiovascular disease, daily drinking, and current smoking. In the subgroup analysis of female participants and participants with diabetes and CKD, a significant association was observed between +1 mg/dL of uric acid and NOBP. Higher uric acid concentration at baseline was significantly associated with NOBP on the first use of antihypertensive drug(s).

Prevalence and potential relevance of hyperuricemia in pediatric kidney transplant recipients—a CERTAIN registry analysis

“…A decline in GFR can be slowed and/or the degree of hypertension can be ameliorated by uric acid-lowering therapy in pediatric cohorts. This treatment effect was observed in particular in younger patients, patients with low grades of hypertension (prehypertension) and in patients without proteinuria, 11,12,[33][34][35]41 as these are show significant associations with eGFR and in some studies with blood pressure, 34,41,42,49 the topic of hyperuricemia should not be neglected.…”

“…A decline in GFR can be slowed and/or the degree of hypertension can be ameliorated by uric acid‐lowering therapy in pediatric cohorts. This treatment effect was observed in particular in younger patients, patients with low grades of hypertension (prehypertension) and in patients without proteinuria, 11,12,33–35,41 as these are presumably patients with less pre‐existing kidney injury. A recent monocentric randomized controlled trial by Gaffo et al 42 examined the effect of 300 mg allopurinol in young (18–40 years) adults and could not show a clear beneficial effect on high‐sensitivity C‐reactive protein (hs‐CRP) and blood pressure, but in patients with higher serum uric acid values, the blood pressure‐lowering effect of allopurinol was more pronounced.…”

“…Yet, under specific conditions, higher blood pressure was the consequence of higher serum uric acid levels, as was shown in obese adolescents, in a Japanese community-based cohort and Brazilian school children. 34,41,49 A potential mechanistic explanation gives the observation of Mazzali et al who showed that hyperuricemia in rats leads to increased renin secretion and decreased nitric oxide synthesis in the kidney, thus promoting hypertension. 52 The type of immunosuppressive medication was not a risk factor for higher serum uric acid levels in this study.…”

Monocyte to high-density lipoprotein cholesterol ratio and serum uric acid in Chinese adults: a cross-sectional study

“…All evidence suggests that MHR is positively related to serum uric acid levels. Clearly, the risks factors for hyperuricemia and gout include the male sex [ 29 ], age [ 30 ], BMI [ 2 , 31 , 32 ], blood pressure [ 32 , 33 ], alcohol consumption [ 34 , 35 ], and physical activity [ 36 ].…”

Monocyte to High-Density Lipoprotein Cholesterol Ratio (MHR) and Serum Uric Acid in Chinese Adults: A Cross-Sectional Study

“…For every SD increase in MHR, serum uric acid increased by 110.9 mmol/l less in occasional smokers and 134.1 mmol/l less in smokers, compared to the nonsmokers. Clearly, the risks for the prevalence of hyperuricemia and gout include male (19), age (20), BMI (2,21,22), blood pressure (22,23), alcohol consumption (24,25) and physical activity(26). There is no consensus on the relationship between smoking and the prevalence of hyperuricemia and gout yet (27).…”