Distinct Uric Acid Trajectories Are Associated With Different Risks of Incident Hypertension in Middle-Aged Adults

Abstract

Objectives: To identify common uric acid (UA) trajectories in middle-aged adults and to examine their association with the risk of hypertension.

Patients and methods: This prospective cohort included 5758 participants who were aged between 30 and 60 years without hypertension on or before June 1, 2011. Latent mixture modeling was used to identify UA trajectories from June 1, 2005, through June 1, 2011, as the predictor. Incident hypertension from June 1, 2011, through June 1, 2017, was used as the outcome.

Results: We detected 5 distinct trajectory groups of UA in both men and women: low-stable (for women, n=720 [24.6%]; for men, n=732 [25.9%]), low-increasing (for women, n=599 [20.4%]; for men, n=696 [24.6%]), moderate-increasing (for women, n=660 [22.5%]; for men, n=634 [22.4%]), high-decreasing (for women, n=314 [10.7%]; for men, n=227 [8.0%]), and high-stable (for women, n=638, 21.8 %; for men, n=538, 19.0%). We observed that 284 women developed hypertension during a median follow-up of 5.9 years (range, 0.8-6.2 years) and 674 men developed hypertension during a median follow-up of 5.9 years (range, 0.7-6.2 years). Compared with the low-stable group, the moderate-increasing group had the highest risk, with adjusted hazard ratios (HRs) of 2.48 (95% CI, 1.64-3.74) in women and 1.84 (95% CI, 1.43-2.35) in men, followed by the high-stable group, with adjusted HRs of 1.97 (95% CI, 1.29-3.01) in women and 1.45 (95% CI, 1.15-1.88) in men. Notably, the low-increasing group with UA in the normal range also exhibited an increased risk, with adjusted HRs of 1.83 (95% CI, 1.20-2.79) in women and 1.42 (95% CI, 1.10-1.83) in men. The high-decreasing group did not exhibit a substantially increased risk. These observed associations between UA trajectories and hypertension were independent of concurrent weight change.

Conclusion: Our results suggest that distinct trajectories of UA are differently associated with hypertension risk in middle-aged adults.