Hyperuricemia and coronary heart disease: A systematic review and meta‐analysis

Abstract

BACKGROUND The role of serum uric acid as an independent risk factor for cardiovascular disease remains unclear although hyperuricemia is associated with cardiovascular disease such as coronary heart disease (CHD), stroke and hypertension. METHODS A systematic review and meta-analysis using a random-effects model was conducted to determine the risk of CHD associated with hyperuricemia in adults. Studies of hyperuricemia and CHD were identified by searching major electronic databases using the Medical Subject Headings and keywords without language restriction (through February 2009). Only prospective cohort studies were included if they had data on CHD incidences or mortalities related to serum uric acid levels in adults. RESULTS 26 eligible studies of 402,997 adults were identified. Hyperuricemia was associated with an increased risk of CHD incidence (unadjusted risk ratio (RR) 1.34; 95% confidence interval (CI) 1.19-1.49) and mortality (unadjusted RR 1.46; 95% CI 1.20-1.73). When adjusted for potential confounding, the pooled RR was 1.09 (95% CI: 1.03-1.16) for CHD incidence and 1.16 (95% CI: 1.01-1.30) for mortality. For each increase of 1 mg/dl in uric acid level, the pooled multivariate RR for CHD mortality was 1.12 (95% CI: 1.05-1.19). Subgroup analyses showed no significant association between hyperuricemia and CHD incidence/mortality in men, but an increased risk for CHD mortality in women (RR 1.67; 95% CI: 1.30-2.04). CONCLUSION Hyperuricemia may marginally increase the risk of CHD events, independently of traditional CHD risk factors. A more pronounced increased risk for CHD mortality in women should be investigated in future research.

Incidence of Hyperuricemia in Patients with Acute Myocardial Infarction – A Case-Control Study

“…In our study, the association was significant for men as compared to women. This was in contrast to the results of a meta-analysis where hyperuricemia was associated with the risk of CAD-related mortality; however, the association was stronger for women than men [14].…”

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“…value of uric acid for the healthy control subjects (P<0.01). These findings backed with the previous research that indicated hyperuricemia is linked to classic cardiometabolic risk factors such glucose intolerance, dyslipidemia, central obesity, and abnormal blood pressure [22]. In this investigation, the mean standard deviation of uric acid for the T2DM group was not significant, contradicting a previous study [23] that indicated the prevalence of hyperuricemia among type 2 diabetes patients [23].…”

Repeated measurements of serum urate and mortality: a prospective cohort study of 152,358 individuals over 8 years of follow-up

“…This relationship is consistent with previous findings from studies of Asian general population cohorts [44,45]. Results from our current study further showed that the association remained significant and independent of kidney function [21,49]. In our study, in the analysis of serum urate measured at baseline in relation to all-cause mortality, the multivariate HRs for Q1, Q2, Q4, and Q5 h/week, relative to Q3, were 1.03 (95% CI 0.96-1.11), 1.00 (95% CI 0.93-1.08), 1.03 (95% CI 0.96-1.11), and 1.10 (95% CI 1.02-1.18), respectively.…”