Uric Acid Level and Elevated Blood Pressure in US Adolescents

Abstract

Uric acid is associated with cardiovascular disease (CVD) and CVD risk factors in adults, including chronic kidney disease, coronary artery disease, stroke, diabetes, preeclampsia, and hypertension. We examined the association between uric acid and elevated blood pressure in a large, nationally representative cohort of U.S. adolescents, a population with a relatively low prevalence of CVD and CVD risk factors. Among 6,036 adolescents 12-17 years of age examined in the 1999-2006 National Health and Nutrition Examination Survey (NHANES) the mean age was 14.5 years, 17% were obese (body mass index [BMI] ≥95th percentile), and 3.3% had elevated blood pressure. Mean serum uric acid level was 5.0 mg/dL and 34% had a uric acid level ≥5.5 mg/dL. In analyses adjusted for age, sex, race/ethnicity and BMI percentile, the odds ratio of elevated blood pressure, defined as a systolic or diastolic blood pressure ≥95th percentile for age, sex and height, for each 0.1 mg/dL increase in uric acid level was 1.38 (95% confidence interval [CI], 1.16 to 1.65). Compared to <5.5 mg/dL, participants with a uric acid level ≥5.5 mg/dL had a 2.03 times higher odds of having elevated blood pressure (95% CI, 1.38 to 3.00). In conclusion, increasing levels of serum uric acid are associated with elevated blood pressure in healthy U.S. adolescents. Additional prospective studies and clinical trials are needed to determine if uric acid is merely a marker in a complex metabolic pathway, or causal of hypertension and thus a potential screening and therapeutic target.

Nitroso-Redox Balance and Mitochondrial Homeostasis Are Regulated bySTOX1, a Pre-Eclampsia-Associated Gene

“…Nitrotyrosine strongly marks the vasculature of pre-eclamptic placentas (8). Recently, uric acid has been reported to mark hypertension and endothelial damage in pre-eclampsia (41). Thus, uric acid could be considered a physiological protective response against peroxynitrite accumulation, as it is a natural strong peroxynitrite scavenger that inhibits inflammation (27).…”

Zalecenia Sekcji Pediatrycznej Polskiego Towarzystwa Nadciśnienia Tętniczego dotyczące postępowania diagnostycznego i terapeutycznego w nadciśnieniu tętniczym u dzieci i młodzieży

“…However, it is not clear whether increased serum uric acid concentration is a primary phenomenon or occurs secondarily to subclinical renal damage [35,36]. Clinical trials and population studies show that in adolescents aged 12-17 years, uric acid > 5.5 mg/dl is associated with a 2-fold higher risk of primary hypertension.…”

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

“…En relación a esta última pregunta, se ha encontrado que los niveles de ácido úrico en cordón umbilical se correlacionan muy bien (r = 0,70, p < 0,001) con los niveles encontrados en la madre, tanto en embarazos normales como en pre-eclampsia 22 , y además se conoce que los niños nacidos de bajo peso para la edad gestacional o prematuros (complicaciones frecuentes de embarazos con pre-eclampsia) muestran niveles altos de ácido úrico 23 . 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 .…”