Survey on uric acid in Chinese subjects with essential hypertension (SUCCESS): a nationwide cross-sectional study

Jing Liu; Luyuan Chen; Hong Yuan; Kai Huang; Guangping Li; Ningling Sun; Yong Huo

doi:10.21037/atm-20-3458

Survey on uric acid in Chinese subjects with essential hypertension (SUCCESS): a nationwide cross-sectional study

Ann Transl Med. 2021 Jan;9(1):27. doi: 10.21037/atm-20-3458.

Authors

Jing Liu¹, Luyuan Chen², Hong Yuan³, Kai Huang⁴, Guangping Li⁵, Ningling Sun¹, Yong Huo⁶

Affiliations

¹ Department of Cardiology, Peking University People's Hospital, Beijing, China.
² Department of Cardiology, Guangdong Provincial People's Hospital, Guangzhou, China.
³ Department of Cardiology, The Third Xiangya Hospital of Central South University, Changsha, China.
⁴ Department of Cardiology, Union Hospital Affiliated with Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
⁵ Department of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, China.
⁶ Department of Cardiology, Peking University First Hospital, Beijing, Chin.

Abstract

Background: Hyperuricemia (HUA) is associated with hypertension and increased cardiovascular risk. Current data regarding the prevalence of HUA in Chinese hypertensive patients are lacking. Our study aims to explore the prevalence and determinants of HUA in Chinese hypertensive adults.

Methods: Treatment-naive hypertensive adults or those taking single antihypertensive agent were included in a nationwide cross-sectional study. Basic demographics, antihypertensive medications, serum uric acid (UA), and other parameters were documented.

Results: The overall prevalence rate of HUA was 38.7% among 33,785 valid cases, 35.1% for males (UA >420 µmol/L), and 45.2% for females (UA >360 µmol/L). A multiple logistic regression analysis, adjusted for demographic and clinical factors (model 1), revealed that female sex [odds ratio (OR), 95% CI, 1.43, 1.36-1.51], age of ≥65 years (1.12, 1.05-1.19), low evaluated glomerular filtration rate [eGFR; 2.06, 1.91-2.23, the lowest [Q1] vs. the highest quartile (Q4)], unmarried (1.58, 1.10-2.27), Western China residency (3.21, 3.33-3.91), longer hypertension duration (1.97, 1.78-2.12, Q4 vs. Q1) and aspirin use (1.21, 1.14-1.29) were associated with HUA. In a multiple logistic regression analysis adjusted for clinical and metabolic parameters (model 2), female sex (OR, 95% CI, 1.34, 1.27-1.41), age of ≥65 years (1.09, 1.03-1.16), low eGFR (2.35, 2.19-2.52, Q1 vs. Q4), new-onset hypertension (2.01, 1.73-2.33), higher quartile of fasting blood glucose (FBG), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) levels, and body mass index (BMI) were associated with higher risk of HUA (1.89, 1.76-2.03; 2.15, 1.99-2.31; 2.86, 2.67-3.06; 1.27, 1.27-1.36, respectively, Q4 vs. Q1). Losartan, valsartan, and nifedipine were associated with lower risk of HUA (OR, 95% CI, 0.77, 0.67-0.88, 0.68, 0.60-0.77; 0.87, 0.77-0.99, 0.79, 0.70-0.89 and 0.80, 0.70-0.91, 0.82, 0.72-0.92), respectively, in models 1 and 2.

Conclusions: The prevalence rate of HUA in Chinese hypertensive patients was 38.7%. Female sex, aging (≥65 years), and low eGFR were independent predictors of HUA. HUA was lower among the patients who were taking losartan, valsartan, and nifedipine. Western region residents, new-onset hypertension, longer hypertension duration, aspirin use, higher FBG, TG, LDL-C levels and BMI were potential risk factors for HUA.

Keywords: Uric acid (UA); hypertension; hyperuricemia (HUA).