Uric acid level and its association with carotid intima–media thickness in patients with hypertension

Tavıl, Yusuf; Kaya, Mehmet; Oktar, Suna Özhan; Şen, Nihat; Okyay, Kaan; Yazici, Hüseyin; Çengel, Atiye

doi:10.1016/j.atherosclerosis.2007.03.008

Cited by 90 publications

(91 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…To date, a few studies have specifically evaluated the association of SUA and carotid atherosclerosis, with some reporting higher SUA levels to be associated with carotid atherosclerosis 20,22,23,26 , consistent with our findings, while others found no association 21,24,25 . Prior epidemiologic studies of hyperuricemia and adverse clinical cardiovascular outcomes have also been conflicting.…”

Section: Discussionsupporting

confidence: 90%

“…If hyperuricemia is indeed an independent risk factor for CVD, it might motivate a change in traditional treatment recommendations. [20][21][22][23][24][25][26] . Such conflicting results may in part be related to differences in analytic approaches and/or effectiveness of controlling for potential confounding.…”

Section: Nih Public Accessmentioning

confidence: 99%

“…This association was consistent regardless of the presence or absence of conditions that may be associated with both uric acid and carotid atherosclerosis. While the uricosuric effects of estrogen 35 and the lower likelihood of preclinical atherosclerotic disease in premenopausal women may account for lack of association noted among women, hyperuricemia appeared to be associated with a higher prevalence of carotid plaques among postmenopausal women (women ≥ age 55 yrs).To date, a few studies have specifically evaluated the association of SUA and carotid atherosclerosis, with some reporting higher SUA levels to be associated with carotid atherosclerosis 20,22,23,26 , consistent with our findings, while others found no association 21,24,25 . Prior epidemiologic studies of hyperuricemia and adverse clinical cardiovascular outcomes have also been conflicting.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Serum Uric Acid Is Associated with Carotid Plaques: The National Heart, Lung, and Blood Institute Family Heart Study

Neogi

Ellison

Hunt³

et al. 2009

J Rheumatol

View full text Add to dashboard Cite

Objective-To examine the association of serum uric acid (SUA) with a marker of preclinical cardiovascular disease (CVD), carotid atherosclerotic plaques (PLQ), where early evidence of risk may be evident, focusing on individuals without CV risk factors.Methods-The National Heart, Lung, and Blood Institute Family Heart Study is a multicenter study designed to assess risk factors for heart disease. PLQ were assessed with carotid ultrasound. We conducted sex-specific logistic regression to assess the association of SUA with presence of PLQ, including analyses among persons without risk factors related to both CVD and hyperuricemia.Results-In total, 4866 participants had both SUA and carotid ultrasound assessed (54% women, mean age 52 yrs, mean body mass index 27.6). The association of SUA with PLQ increased with increasing SUA levels, demonstrating a dose-response relation for men [OR 1.0, 1.29, 1.61, 1.75, for SUA categories < 5 (reference), 5 to < 6, 6 to < 6.8, ≥ 6.8 mg/dl, respectively; p = 0.002]. Similar associations were found in men without CV risk factors. We found no relation of SUA with PLQ in women. Studies examining the relation of hyperuricemia with cardiovascular disease (CVD) have had conflicting results. While many have found an independent association of higher serum uric acid (SUA) concentrations with increased risk of adverse cardiovascular outcomes 1-7 , others have not [8][9][10] . Biological mechanisms linking hyperuricemia to CVD risk exist, but direct effects of uric acid on the vasculature remain controversial 11,12 . Moreover, some have argued that the positive association between SUA and CVD may be due to the concurrent cardiovascular comorbidities seen in many persons with hyperuricemia, including diabetes, dyslipidemia, hypertension, and obesity [13][14][15] . Conclusion-In NIH Public AccessClarifying the relation of SUA to CVD risk has clinical implications and public health importance. First, there has been a secular increase in the incidence and prevalence of gout and hyperuricemia 16,17 . Second, asymptomatic hyperuricemia is presently not an indication for urate-lowering therapy. If hyperuricemia is indeed an independent risk factor for CVD, it might motivate a change in traditional treatment recommendations. [20][21][22][23][24][25][26] . Such conflicting results may in part be related to differences in analytic approaches and/or effectiveness of controlling for potential confounding.Further, prior studies have not examined SUA's effects in individuals who are free from comorbidities, which themselves can both increase SUA and increase risk for preclinical CVD. If SUA were associated with preclinical CVD in persons without any such comorbidities, it would constitute stronger evidence for SUA's association with CVD than has been presented in previous studies.We evaluated the association of SUA with carotid plaques in a large multicenter study, the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study, and further assessed these associations for the modifyi...

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Nih Public Accessmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Serum Uric Acid Is Associated with Carotid Plaques: The National Heart, Lung, and Blood Institute Family Heart Study

Neogi

Ellison

Hunt³

et al. 2009

J Rheumatol

View full text Add to dashboard Cite

show abstract

“…However, even after correcting for obesity risk factors, the strong correlation remained relatively strong and highly significant in the Caucasian men. According to Tavil et al, 38 higher UA levels are associated with atherogenesis. This suggests that a rise in UA levels with a concomitant rise in triglyceride levels may have some role in the aetiology of cardiovascular dysfunction.…”

Section: Discussionmentioning

confidence: 98%

Uric acid and the cardiovascular profile of African and Caucasian men

2010

View full text Add to dashboard Cite

The African population is considered a high-risk group for the development of hypertension, and identifying risk factors are therefore essential in preventive actions against cardiovascular disease (CVD). Elevated levels of uric acid (UA) are often associated with CVD. Our first aim was to establish possible ethnic differences in UA levels between African and Caucasian men. Our second aim was to determine any associations between UA levels and cardio-metabolic variables, and also how these correlates differ between the two groups. African (N ¼ 87) and Caucasian (N ¼ 121) men participated in this cross-sectional study. Our results have shown that African men had significantly lower (353±87.7 vs 401 ± 98.2; Po0.01) UA levels compared with Caucasian men. Waist circumference and triglycerides correlated strongly with UA in both ethnic groups. This was confirmed with a forward stepwise multiple regression analysis. After adjustment for confounders, the correlation between UA and triglycerides remained significant only in the Caucasians (r ¼ 0.29; P ¼ 0.02), whereas only the African men showed an independent correlation between UA and total peripheral resistance (TPR) (r ¼ 0.23; P ¼ 0.04). TPR increased significantly across UA tertiles only in the African men (P ¼ 0.01 vs P ¼ 0.96).In conclusion, despite their lower UA levels, Africans showed an independent relationship between UA and vascular resistance, indicating a possible explanation for their high prevalence of hypertension.

show abstract

“…In the Framingham cohort, investigators concluded that hyperuricemia was a covariable of other known cardiovascular risk factors for cardiac deaths and coronary heart disease (18). More recently, data appear to be swinging the interpretation the other way, indicating that hyperuricemia predisposes to plaque formation and endothelial dysfunction, as assessed by ultrasonography (19)(20)(21). Hyperuricemia was also reported to be an independent risk factor for cardiovascular mortality (22,23).…”

Section: Hyperuricemia Insulin Resistance Hypertension and Cardiovmentioning

confidence: 99%

Uric acid transport and disease

Thorens²

2010

J. Clin. Invest.

642

496

View full text Add to dashboard Cite

Uric acid is the metabolic end product of purine metabolism in humans. It has antioxidant properties that may be protective but can also be pro-oxidant, depending on its chemical microenvironment. Hyperuricemia predisposes to disease through the formation of urate crystals that cause gout, but hyperuricemia, independent of crystal formation, has also been linked with hypertension, atherosclerosis, insulin resistance, and diabetes. We discuss here the biology of urate metabolism and its role in disease. We also cover the genetics of urate transport, including URAT1, and recent studies identifying SLC2A9, which encodes the glucose transporter family isoform Glut9, as a major determinant of plasma uric acid levels and of gout development.Conflict of interest: Alexander So has acted as a consultant and advisor for Novartis.Citation for this article:

show abstract

Uric acid level and its association with carotid intima–media thickness in patients with hypertension

Cited by 90 publications

References 21 publications

Serum Uric Acid Is Associated with Carotid Plaques: The National Heart, Lung, and Blood Institute Family Heart Study

Serum Uric Acid Is Associated with Carotid Plaques: The National Heart, Lung, and Blood Institute Family Heart Study

Uric acid and the cardiovascular profile of African and Caucasian men

Uric acid transport and disease

Contact Info

Product

Resources

About