Uric acid is an independent predictor of arterial stiffness in hypertensive patients

Abstract

Increased arterial stiffness is an important marker for target organ damage in essential hypertension. Both serum uric acid (UA) and C-reactive protein (CRP) were reported to be associated with target organ damage. However, the influences of UA and CRP on large arterial stiffness were not well elucidated. This study included 200 essential hypertension patients (64 women) whose age was between 20 and 50 years old (mean age 41 +/- 8 years). None of the patients had diabetes mellitus or overt end-organ damage. Arterial stiffness was assessed by pulse-wave velocity (PWV) measured by tonometry from carotid to radial artery. Serum UA, high-sensitivity CRP (hsCRP), glucose, insulin, and lipid profiles were measured at the same time in each patient. PWV levels were significantly correlated with mean blood pressure (r = 0.245, P < 0.001), diastolic blood pressure (r = 0.323, P < 0.001), high-density lipoprotein (r = -0.169, P = 0.016), and UA (r = 0.234, P = 0.001), but not age, body mass index, blood sugar, insulin, low-density lipoprotein, triglyceride, and hsCRP. Pulse-wave velocity levels were significantly higher in males (8.9 +/- 1.2 vs 8.2 +/- 1.2 m/s, P < 0.001) and smokers (9.3 +/- 1.1 vs 8.5 +/- 1.2 m/s, P < 0.001). Uric acid was significantly correlated with hsCRP (r = 0.294, P < 0.001). After multivariate analysis controlling for all possible confounding factors, UA (odds ratio 1.28, 95% confidence interval 1.02-1.61, P = 0.032) was still independently associated with increased PWV. In conclusion, UA but not hsCRP was independently associated with increased PWV in essential hypertension. Although UA was correlated with hsCRP, the association between UA and PWV was not through the effect of enhanced inflammation.

Relationships between serum uric acid, adiponectin and arterial stiffness in postmenopausal women

“…Furthermore, in multivariate logistic regression analysis, uric acid was an independent contributor to increased PWV in postmenopausal women even after adjusting for other cardiovascular risk factors including insulin resistance. Previous study has also reported that uric acid was associated with increased arterial stiffness in hypertensive patients [19]. The mechanism underlying the relationship of uric acid and arterial stiffness is not completely understood, but it was explained that endothelial dysfunction was associated with hyperuricemia [33].…”

“…There are few reports of the relationship between uric acid and PWV [13,18,19], and the results of these studies were inconsistent. Moreover, there is no information on the relationship between uric acid and PWV in postmenopausal women.…”

Significance of high-normal serum uric acid level as a risk factor for arterial stiffness in healthy Korean men

“…As renal function deteriorated in the hypertensive patients, arterial stiffness could be overestimated. 22 Autonomic tone, and sympathetic/parasympathetic activity may increase vascular tone and resistance. 23 Therefore, we considered resting heart rate as a confounding factor.…”

Association between serum uric acid, aortic, carotid and femoral stiffness among adults aged 40–75 years without and with type 2 diabetes mellitus

“…Arterial stiffness can be measured at different arterial segments and sites, and by use of different techniques which include regional carotid-femoral pulse wave velocity (cfPWV), brachialankle PWV (baPWV), and local carotid and femoral stiffness. Several studies have assessed the association between uric acid and regional arterial stiffness, with conflicting results [11][12][13][14][15][16][17][18][19][20][21]. However, in most of these studies [12,14,[16][17][18][19][20], arterial stiffness was determined via the assessment of baPWV.…”