Hyperuricemia and its association with carotid intima-media thickness in hypertensive and non hypertensive patients

Abstract

Carotid intima-media thickness (C-IMT) measured noninvasively by ultrasonography is widely used as a marker for increased risk of cardiovascular disease. Also hyperuricemia (HU) is a well recognized risk factor for cardiovascular diseases. The study was designed to assess the relation between hyperuricemia and carotid intima-media thickness C-IMT in patients with and without hypertension (HTN).This study included 126 patients divided into four groups: (1) Group A, included 59 hypertensive patients with hyperuricemia. (2) Group B, included 29 hypertensive patients without hyperuricemia. (3) Group C, included 17 patients with hyperuricemia and normal blood pressure without history of hypertension. (4) Group D, included 21 control subjects.We measured carotid intima-media thickness by B-mode ultrasound in the common carotid and internal carotid artery. Routine echocardiography and uric acid level was assessed for all patients.We found that C-IMT was significantly higher in group A, B and C than group D; and it was significantly higher in group A than B. This means that C-IMT is significantly higher in all hypertensive groups than control group but it was significantly higher in hypertensive hyperuricemia (group A) than those hypertensives without hyperuricemia. We also observed a higher C-IMT in hyperuricemic non hypertensive patients than control group this means that hyperuricemia per se could be a risk factor for atherosclerosis. Uric acid levels among the whole number of patients included in the study and among the groups with hyperuricemia (group A and group C) were positively correlated with the intimal-media thickness (IMT) while there were no correlations in the other two groups without hyperuricemia.We found that left ventricular hypertrophy (LVH) was significantly higher in hypertensive patients (group A&B) than normotensives (group C&D) either with or without hyperuricemia and this was evident in the hypertensive hyperuricemic patients (group A); but unexpectedly we observed the presence of LVH in the hyperuricemic non hypertensive patients (group C) which was significantly higher than the control group (group D). This means that hyperuricemia is a risk factor for development of LVH hypertrophy independently of hypertension.Therefore, higher serum uric acid levels are associated with increased C-IMT and left ventricular hypertrophy in hypertensive and even non hypertensive patients. So, early screening for hyperuricemia and lowering serum uric acid levels might be beneficial in slowing progression of atherogenesis.

Sex-related Association of Serum Uric Acid and Carotid Atherosclerosis in a Hypertensive Nigerian Population

“…This study also showed that CIMT was higher in normotensive hyperuricemic controls than among the normotensive non hyperuricemic controls, and that the difference was statistically significant. This was consistent with the results by Elsayed et al [40] and Tavil et al [41]. This means that hyperuricemia could be a risk factor for atherogenesis independent from hypertension.…”

“…This means hyperuricemia per se could be a risk factor for atherosclerosis in hypertensive patients and by necessary implication an indicator of increased cardiovascular disease. This is consistent with the findings by Elsayed et al [40]. This study also showed that CIMT was higher in normotensive hyperuricemic controls than among the normotensive non hyperuricemic controls, and that the difference was statistically significant.…”

Association of Hyperuricemia With Carotid Intima-Media Thickness, Albuminuria, Diabetes, Hypertension in Chronic Renal Failure

“…In concordance with "Normative aging study" [25], Elsayed et al [26], Tavil Y et al [2] our study also demonstrated that the hyperuricemia predicts the development of hypertension. So, controls of hyperuricemia can control hypertension in CRF patients and halt or slow the further progression of atherosclerosis.…”

Association between elevated carotid intima‐media thickness and serum uric acid levels among patients with essential hypertension in primary care setting in Sungai Buloh, Malaysia

“…Several studies had found elevated SUA to be significantly associated with subclinical atherosclerosis among the hypertensive population. Both Tavil et al 22 and Elsayed et al 23 found in their studies that CIMT level was statistically higher among the hypertensive population with elevated SUA when compared with a control group with normal blood pressure and normal SUA. These results were also supported by Mutluay et al 24 whose findings showed that CIMT level was significantly associated with hyperuricemia in hypertensive subjects as compared with hypertensive subjects without elevated SUA, even after controlling for metabolic and clinical factors.…”