Hyperuricemia and incident hypertension: A systematic review and meta‐analysis

Abstract

Objective. A novel rodent model and a recent randomized trial of hyperuricemic adolescents with hypertension suggest a pathogenetic role of uric acid in hypertension, but it remains unknown whether these findings would be applicable to adult populations where the larger disease burden exists. We conducted a systematic review and meta-analysis to determine if hyperuricemia was associated with incident hypertension, particularly in various demographic subgroups. Methods. We searched major electronic databases using medical subject headings and keywords without language restrictions (through April 2010). We included prospective cohort studies with data on incident hypertension related to serum uric acid levels. Data abstraction was conducted in duplicate. We analyzed age, sex, and race subgroups. Results. A total of 18 prospective cohort studies representing data from 55,607 participants were included. Hyperuricemia was associated with an increased risk for incident hypertension (adjusted risk ratio [RR] 1.41, 95% confidence interval [95% CI] 1.23-1.58). For a 1 mg/dl increase in uric acid level, the pooled RR for incident hypertension after adjusting for potential confounding was 1.13 (95% CI 1.06 -1.20). These effects were significantly larger in younger study populations (P ‫؍‬ 0.02) and tended to be larger in women (P ‫؍‬ 0.059). Two studies suggested that the effect may also be larger among African American individuals. Furthermore, later publication year and US-based studies were significantly associated with a lower effect estimate (P values <0.02). Conclusion. Hyperuricemia is associated with an increased risk for incident hypertension, independent of traditional hypertension risk factors. This risk appears more pronounced in younger individuals and women.

Uric acid predicts mortality and ischaemic stroke in subjects with diastolic dysfunction: the Tromsø Study 1994–2013

“…8 UA is closely associated with hypertension; a meta-analysis reported that higher UA was associated with a statistically significant elevation in incident hypertension. 17 In a recent prospective cohort study, we demonstrated that UA was associated with development of elevated blood pressure in overweight subjects. 10 Hypertension is also closely associated with DD, 5 both being implicated in the development of HFpEF.…”

Effects of serum uric acid on blood-pressure lowering treatment

“…SUA was also found to predict new-onset hypertension in a Japanese general population 12 , and a recent meta-analysis had found similar data 13 .…”

Purinas y ácido úrico en pre-eclampsia: interacciones fisiopatológicas y proyecciones en investigación

“…Asimismo, los niños con elevación de la presión arterial presentan niveles altos de ácido úrico comparado con niños normotensos 23 , lo cual estaría asociado a un elevado riesgo (~2 veces) de hipertensión en la adolescencia 24 . Para complementar, en adultos y sobre todo en mujeres, se ha reportado que la elevación en los niveles de ácido úrico constituye un factor de riesgo independiente para hipertensión 25 o muerte por enfermedad coronaria 26 . Cabe resaltar, que no se ha estudiado la relación entre el ácido úrico al nacimiento y el riesgo de hipertensión del embarazo en la vida adulta.…”