Connection between uric acid and cardiovascular risk factors in hypertensive patients
https://doi.org/10.38109/2075-082X-2023-3-19-25
Abstract
The aim of the research is to analyze correlations between uric acid and cardiovascular risk factors (age, body mass index, waist circumference, total cholesterol and low-density lipoprotein cholesterol levels, glucose) and glomerular filtration Rate in outpatient care hypertensive patients. The research was based on the data of 1285 ambulatory patients from the national register of hypertension. Hyperuricemia was detected in 28,4% of cases. A positive correlation was established between uric acid and waist circumference, body mass index; negative – between uric acid and kidney function deterioration (based on glomerular filtration rate). It was stated that diuretic therapy and smoking are associated with the increase in uric acid serum levels. The study of cardiovascular risk factors frequency in patients with hypertension and hyperuricemia concluded that 80% had more than 1 additional risk factor; combination of ≥3 risk factors occurred in males significantly more often than in females.
Acquired data proves that uric acid is closely related to disturbance in metabolic factors, kidney function and diuretic therapy admission, which makes it essential to control its levels in hypertensive patients, as well as to use measures approved by the modern guidelines to decrease uric acid in patients with hyperuricemia.
About the Authors
Natavan Z. MusaevaRussian Federation
Natavan Z. Musaeva, Clinical Resident, Hypertension Department,
15A Academician Chazova str., Moscow 121552.
Elena V. Oshchepkova
Russian Federation
Elena V. Oshchepkova, Dr. Of Sci. (Med.), Professor, Chief Researcher, Hypertension Department,
15A Academician Chazova str., Moscow 121552.
Anna V. Aksenova
Russian Federation
Anna V. Aksenova, Cand. Of Sci. (Med.), Senior Researcher, Hypertension Department,
15A Academician Chazova str., Moscow 121552.
Timur M. Gurtsiev
Russian Federation
Timur M. Gurtsiev, Clinical Resident, Hypertension Department,
15A Academician Chazova str., Moscow 121552.
Irina E. Chazova
Russian Federation
Irina E. Chazova, Dr. Of Sci. (Med.), Professor, Academician of RAS, Head of Hypertension Department, Deputy General Director for Scientific and Expert Work,
15A Academician Chazova str., Moscow 121552.
References
1. Biological chemistry. Textbook for universities. Edited by corresponding member of RAS, prof. E.S. Severina – M.: GEOTAR-Media, 2011. – 624 p.: ill. (in Russ.).
2. Chazova I.E., Zhernakova Yu.V., Kislyak O.A., Podzolkov V.I., Oshchepkova E.V., Mironova O.Yu., Blinova N.V. Consensus on patients with hyperuricemia and high cardiovascular risk treatment: 2022. Systemic Hypertension. 2022;19(1):5-22. (In Russ.). https://doi.org/10.38109/2075-082X-2022-1-5-22
3. Stewart DJ, Langlois V, Noone D. Hyperuricemia and hypertension: links and risks. Integr Blood Press Control. (2019) 12:43–62. https://doi.org/10.2147/IBPC.S184685
4. Shalnova S.A., Deev A.D., Artamonov G.V., Duplyakov D.V., Efanov A.Yu., Zhernakova Yu.V., Konradi A.O., Libis R.A., Muromtseva G.A., Nedogoda S.V., Oschepkova E.V., Romanchuk S.V., Rotar O.P., Titov V.N., Toguzova Z.A., Trubacheva I.A., Furmenko G.I., Shlyakhto E.V., Boytsov S.A. Hyperuricemia and its correlates in the Russian population (results of ESSE-RF epidemiological study). Rational Pharmacotherapy in Cardiology. 2014;10(2):153-159. (In Russ.). https://doi.org/10.20996/1819-6446-2014-10-2-153-159
5. Elfishawi MM, Zleik N, Kvrgic Z, Michet CJ Jr, Crowson CS, Matteson EL, Bongartz T. The Rising Incidence of Gout and the Increasing Burden of Comorbidities: A Population-based Study over 20 Years. J Rheumatol. 2018 Apr;45(4):574-579. Epub 2017 Dec 15. PMID: 29247151; PMCID: PMC5880714. https://doi.org/10.3899/jrheum.170806
6. Del Pinto R, Viazzi F, Pontremoli R, Ferri C, Carubbi F, Russo E. The URRAH study. Panminerva Med. 2021 Dec;63(4):416-423. Epub 2021 Mar 26. PMID: 33765764. https://doi.org/10.23736/S0031-0808.21.04357-3
7. Ruocco G, Palazzuoli A. Hyperuricemia in US Population with Heart Failure: Causal or Incidental Bystander? Cardiorenal Med. 2019;9(6):341-343. Epub 2019 Oct 23. PMID: 31645036. https://doi.org/10.1159/000503058
8. Chazova I.E., Zhernakova Ju.V., Kisliak O.A. et al. Consensus on patients with hyperuricemia and high cardiovascular risk treatment. Systemic Hypertension. 2019;16(4):8-21. (in Russ.). https://doi.org/10.26442/2075082X.2019.4.190686
9. Borghi C, Domienik-Karłowicz J, Tykarski A, et al. Expert consensus for the diagnosis and treatment of patient with hyperuricemia and high cardiovascular risk: 2021 update. Cardiol J. 2021;28(1):1-14. https://doi.org/10.5603/CJ.a2021.0001
10. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007–2008. Arthritis Rheum. 2011;63(10):3136-3141. https://doi.org/10.1002/art.30520
11. Chen-Xu M, Yokose C, Rai SK, et al. Hyperuricemia in the United States and Decadal Trends: The National Health and Nutrition Examination Survey, 2007-2016. Arthritis Rheumatol. 2019;71(6):991-999. https://doi.org/10.1002/art.40807
12. Grayson PC, Kim SY, LaValley M, et al. Hyperuricemia and incident hypertension: a systematic review and meta-analysis. Arthritis Care Res (Hoboken) 2011;63(1):102-110. https://doi.org/10.1002/acr.20344
13. Shirasawa T, Ochiai H, Yoshimoto T, et al. Cross-sectional study of associations between normal body weight with central obesity and hyperuricemia in Japan [published correction appears in BMC Endocr Disord. 2020 Feb 21;20(1):26]. BMC Endocr Disord. 2020;20(1):2. Published 2020 Jan 6. https://doi.org/10.1186/s12902-019-0481-1
14. Oshchepkova E.V., Dovgalevsky P.Ya., Gridnev V.I. Registry of arterial hypertension in primary healthcare. State and medicine. Atmosphere. Cardiology News 2006;3:43-44. (in Russ.).
15. Oshchepkova E.V., Dovgalevsky P.Ya., Gridnev V.I., Posnenkova O.M., Kiselev A.R., Dmitriev V.A., Popova Yu.V., Volkova E.N. Structure of primary elements of the database of the Russian register of patients with arterial hypertension, coronary heart disease and chronic heart failure. Cardio-IT 2014;1:0202. (in Russ.). https://doi.org/10.15275/cardioit.2014.0202
16. Stevens P.E., Levin A.; Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2013;158(11):825-830. https://doi.org/10.7326/0003-4819-158-11-201306040-00007
17. Ding N, Long Y, Li C, He L, Su Y. Association of Uric Acid With Blood Pressure in Hypertension Between Treatment Group and Non-treatment Group. Front Cardiovasc Med. 2022 Jan 11;8:751089. https://doi.org/10.3389/fcvm.2021.751089
18. Kuwabara M, Kuwabara R, Niwa K, Hisatome I, Smits G, Roncal-Jimenez CA, MacLean PS, Yracheta JM, Ohno M, Lanaspa MA, Johnson RJ, Jalal DI. Different Risk for Hypertension, Diabetes, Dyslipidemia, and Hyperuricemia According to Level of Body Mass Index in Japanese and American Subjects. Nutrients. 2018 Aug 3;10(8):1011. PMID: 30081468; PMCID: PMC6115805. https://doi.org/10.3390/nu10081011
19. Wang YY, Li L, Cui J, Yin F, Yang F, Yuan DM, Xin HL, Zhang L, Gao WG, Sun JP. Associations between anthropometric parameters (body mass index, waist circumference and waist to hip ratio) and newly diagnosed hyperuricemia in adults in Qingdao, China: A cross-sectional study. Asia Pac J Clin Nutr. 2020;29(4):763-770. PMID: 33377370. https://doi.org/10.6133/apjcn.202012_29(4).0011
20. Obermayr RP, Temml C, Gutjahr G, Knechtelsdorfer M, Oberbauer R, Klauser-Braun R. Elevated uric acid increases the risk for kidney disease. J Am Soc Nephrol. 2008 Dec;19(12):2407-13. Epub 2008 Sep 17. PMID:18799720; PMCID: PMC2588108. https://doi.org/10.1681/ASN.2008010080
21. Madyanov I.V. Hyperuricemia and diabetes mellitus. RMJ. Medical Review. 2019;3(1(I)):20-24. (in Russ.).
22. “Study of the content of uric acid in blood serum and urine in comparison with the state of target organs (vessels, kidneys) in patients with hypertension in the early stages of the disease,” dissertation for the degree of candidate of medical sciences, Institute of Clinical Cardiology named after. A.L. Myasnikov, Russian Cardiology Research and Production Complex of the Ministry of Health and Social Development of the Russian Federation. Gushchina O.V., 2011 (in Russ.).
23. Bazalar-Palacios J, Jaime Miranda J, Carrillo-Larco RM, Gilman RH, Smeeth L, Bernabe-Ortiz A. Aggregation and combination of cardiovascular risk factors and their association with 10-year allcause mortality: the PERU MIGRANT Study. BMC Cardiovasc Disord. 2021 Dec 7;21(1):582. https://doi.org/10.1186/s12872-021-02405-8
Review
For citations:
Musaeva N.Z., Oshchepkova E.V., Aksenova A.V., Gurtsiev T.M., Chazova I.E. Connection between uric acid and cardiovascular risk factors in hypertensive patients. Systemic Hypertension. 2023;20(3):19-25. (In Russ.) https://doi.org/10.38109/2075-082X-2023-3-19-25