Prevalence of hyperuricemia and its association with antihypertensive treatment in hypertensive patients in Taiwan

Abstract

Background: Hyperuricemia is thought to be associated with an increased risk of hypertension, impaired renal function and cardiovascular disease. Our aim is to study the prevalence of hyperuricemia and its association with antihypertensive treatment in Taiwanese hypertensive subjects.

Methods: We recruited 2145 hypertensive subjects from 19 hospitals in four areas of Taiwan. We assessed the prevalence of hyperuricemia and determined the independent risk factors for raised serum uric acid level by multiple logistic regression analyses.

Results: Compared to the general population, hypertensive subjects in Taiwan had a higher prevalence (mean 35% in males, 43% in females) of hyperuricemia; this prevalence being 1.5- and 1.7-fold higher in males and females respectively. Uric acid levels; gout and prevalence of hyperuricemia were found to be highest in the younger age group (20-39 years) and no regional differences were noted. The most important risk factors for hyperuricemia were impaired renal function and diuretic use. Serum uric acid values correlated significantly with four quintiles of serum creatinine (p<0.0001) independent of diuretic use. Diuretic users had a significantly elevated serum uric acid and serum creatinine values than non-users. Among the patients given diuretics, hyperuricemia occurred in 44% of those given thiazides, in 56% of those given loop diuretics, and in 57% of those given aldosterone receptor blockers.

Conclusions: Diuretic usage and renal function status have a strong impact on the prevalence of hyperuricemia in Taiwanese hypertensive subjects. It is still unclear, however, whether diuretics induce renal failure through elevating serum uric acid levels.