Background: There is limited available evidence of a relationship between uric acid (UA) level and stroke in hypertensive populations worldwide. We aimed to estimate the relationship between UA level and stroke in Chinese hypertensive populations.
Methods: A total of 4 710 essentially hypertensive Chinese patients, including 307 with stroke, were recruited consecutively by cluster sampling from 60 communities in Shenzhen from April 2010 to September 2011. Demographic characteristics, UA level and stroke diagnosis were collected from every participant. Logistic regression analysis was used to estimate the association between UA level and stroke.
Results: The study population comprised 2 361 females and 2 349 males, with a mean age of 58 ± 11.75 years. There were significant associations between UA level and stroke and ischaemic stroke (IS) risk for females in the crude model (M0), model 1 (M1) and model 2 (M2), with increasing odds ratios (OR) as the quartiles (Q) increased. The odds of stroke risk was highest in Q4 in M2 (UA > 396 µmol/l, OR: 3.05, 95% CI: 1.74-5.36 and OR: 3.19, 95% CI: 1.74-5.85), but not for males in M0, M1 and M2. A significant dose-response relationship existed between UA level and stroke, and between UA level and IS for females but not for males. Hyperuricaemia (HU) was also significantly associated with stroke and IS for females but not for males. Taking negative uric acid, homocysteine, triglycerides, total cholesterol and low-density lipoprotein cholesterol (UA-Hcy-TG-TC-LDL-C-) as the reference, the combinations of UA+Hcy+TG-TC-LDL-, UA+Hcy+TG+TC+LDL-C- and UA+Hcy+TG+TC+LDL-C+ were significantly associated with the risk of stroke for females (OR = 2.48, 7.85 and 3.04).
Conclusions: High UA level could significantly increase stroke risk in female hypertensive patients. Female hypertensive patients may benefit from managing UA at normal levels for stroke prevention.
Keywords: haemorrhagic stroke; hypertension; hyperuricaemia; ischaemic stroke; stroke; uric acid.