Serum uric acid is an independent predictor for developing prehypertension: a population-based prospective cohort study

Abstract

Although the prevalence of prehypertension is rapidly increasing in China, the medical community has paid little attention to its prevention. Prior studies have demonstrated that uric acid directly contributes to vascular remodelling and endothelial dysfunction. However, few prospective studies have assessed the relationship between serum uric acid and prehypertension. We therefore designed a larger-scale cohort study to examine whether uric acid level is a predictive factor for developing prehypertension in adults. Participants were recruited from Tianjin Medical University General Hospital-Health Management Centre. A prospective assessment (n=15 143) was performed. Participants without a history of hypertension or prehypertension were followed up for 2 to 6 years with a median follow-up duration of 2.8 years. Serum uric acid levels and blood pressure were assessed yearly during the follow-up. Adjusted Cox proportional hazards regression models were used to assess relationships between the quintiles of uric acid levels and the incidence of prehypertension. The incidence of prehypertension was 191 per 1000 person-years. In the final multivariate models, the hazard ratios (95% confidence interval) for prehypertension across uric acid quintiles were 1.00 (reference), 0.98 (0.90-1.07), 1.01 (0.93-1.10), 1.09 (1.001-1.20) and 1.17 (1.06-1.29) (P for trend <0.001), respectively. This population-based prospective cohort study has demonstrated that uric acid level is an independent predictor for developing prehypertension.

Association between urinary sodium excretion and uric acid, and its interaction on the risk of prehypertension among Chinese young adults

“… 47 determined that no association existed between elevated serum UA level and prehypertension; this might be because of higher background rate of prehypertension with increasing age that would contribute to a reduction in the odd ratios for serum UA. Recently, a prospective cohort study demonstrates that serum UA is an independent predictor for developing prehypertension 48 . In addition, Soletsky et al .…”

<p>Hyperuricemia and Hypertension: Links and Risks</p>

“…Another cohort study of 15,143 subjects identified a similar risk for incident prehypertension with a 9% increased risk for those with SUA levels in the fourth quintile of the population, and 17% risk for those with levels in the fifth quintile, compared with those in the bottom quintile. 119 Cicero and colleagues selected 619 individuals from the Brisighella Heart Study and found a significant incremental increase in risk of hypertension and metabolic syndrome, along with an increase of carotid intima media thickness (CIMT), in those progressing from the second to fourth quartile of SUA measurement (from 23% to 56.3% for hypertension prevalence). 120 These were otherwise healthy individuals (mostly adults) without known cardiovascular disease.…”

Uric Acid Is a Strong Risk Marker for Developing Hypertension From Prehypertension

“…Hyperuricemia (elevated serum uric acid) has emerged as one of the strongest risk factors for the development of prehypertension 1 , primary hypertension 2, 3 , and resistant hypertension 4 . Experimentally raising uric acid in rats also causes hypertension.…”