Uric Acid Is Not Associated With Blood Pressure Phenotypes and Target Organ Damage According to Blood Pressure Phenotypes

Anping Cai; Lin Liu; Mohammed Siddiqui; Dan Zhou; Jiyan Chen; David A Calhoun; Songtao Tang; Yingling Zhou; Yingqing Feng

doi:10.1093/ajh/hpaa130

Uric Acid Is Not Associated With Blood Pressure Phenotypes and Target Organ Damage According to Blood Pressure Phenotypes

Am J Hypertens. 2021 Feb 18;34(1):64-72. doi: 10.1093/ajh/hpaa130.

Authors

Anping Cai¹, Lin Liu¹, Mohammed Siddiqui², Dan Zhou¹, Jiyan Chen¹, David A Calhoun², Songtao Tang³, Yingling Zhou¹, Yingqing Feng¹

Affiliations

¹ Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
² Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, USA.
³ Department of Public Health, Community Health Center of the Liaobu County, Dongguan, China.

PMID: 32812633
DOI: 10.1093/ajh/hpaa130

Abstract

Background: Hypertensive patients with increased serum uric acid (SUA) are at increased cardiovascular (CV) risks. Both the European and American hypertension guidelines endorse the utilization of 24 h-ambulatory blood pressure monitoring (24 h-ABPM) for hypertensive patients with increased CV risk. While there is difference in identifying uric acid as a CV risk factor between the European and American guidelines. Therefore, it is unknown whether 24 h-ABPM should be used routinely in hypertensive patients with increased SUA.

Methods: To address this knowledge gap, we investigated (i) the correlation between SUA and 24 h-ABP; (ii) the association between SUA and blood pressure (BP) phenotypes (controlled hypertension [CH], white-coat uncontrolled hypertension [WCUH], masked uncontrolled hypertension [MUCH], and sustained uncontrolled hypertension [SUCH]); (iii) the association between SUA and target organ damage (TOD: microalbuminuria, left ventricular hypertrophy [LVH], and arterial stiffness) according to BP phenotypes.

Results: In 1,336 treated hypertensive patients (mean age 61.2 and female 55.4%), we found (i) there was no correlation between SUA and 24 h, daytime, and nighttime systolic blood pressure/diastolic blood pressure, respectively; (ii) in reference to CH, SUA increase was not associated WCUH (odds ratio [OR] 0.968, P = 0.609), MUCH (OR 1.026, P = 0.545), and SUCH (OR 1.003, P = 0.943); (iii) the overall prevalence of microalbuminuria, LVH, and arterial stiffness was 2.3%, 16.7%, and 23.2%, respectively. After adjustment for covariates, including age, sex, smoking, body mass index, diabetes mellitus, and estimated glomerular filtration rate, there was no association between SUA and TOD in all BP phenotypes.

Conclusions: These preliminary findings did not support routine use of 24 h-ABPM in treated hypertensive patients with increased SUA.

Keywords: ambulatory blood pressure monitoring; blood pressure; blood pressure phenotypes; hypertension; target organ damage; uric acid.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Albuminuria* / diagnosis
Albuminuria* / etiology
Antihypertensive Agents / therapeutic use
Blood Pressure / physiology
Blood Pressure Monitoring, Ambulatory* / methods
Blood Pressure Monitoring, Ambulatory* / standards
Blood Pressure Monitoring, Ambulatory* / statistics & numerical data
Correlation of Data
Female
Glomerular Filtration Rate
Heart Disease Risk Factors
Humans
Hypertension* / blood
Hypertension* / physiopathology
Hypertension* / therapy
Hypertrophy, Left Ventricular* / diagnosis
Hypertrophy, Left Ventricular* / etiology
Male
Middle Aged
Reproducibility of Results
Risk Assessment / methods
Risk Assessment / statistics & numerical data
Uric Acid / blood*
Vascular Stiffness*

Substances

Antihypertensive Agents
Uric Acid