Temporal relationship between hyperuricemia and hypertension and its impact on future risk of cardiovascular disease

Xue Tian; Shuohua Chen; Penglian Wang; Qin Xu; Yijun Zhang; Xiaoli Zhang; Shouling Wu; Yanxia Luo; Anxin Wang

doi:10.1016/j.ejim.2023.02.023

Temporal relationship between hyperuricemia and hypertension and its impact on future risk of cardiovascular disease

Eur J Intern Med. 2023 May:111:82-89. doi: 10.1016/j.ejim.2023.02.023. Epub 2023 Mar 6.

Authors

Xue Tian¹, Shuohua Chen², Penglian Wang³, Qin Xu³, Yijun Zhang¹, Xiaoli Zhang³, Shouling Wu⁴, Yanxia Luo⁵, Anxin Wang⁶

Affiliations

¹ Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
² Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
³ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
⁴ Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China. Electronic address: drwusl@163.com.
⁵ Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China. Electronic address: lyx100@ccmu.edu.cn.
⁶ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: wanganxin@bjtth.org.

PMID: 36890009
DOI: 10.1016/j.ejim.2023.02.023

Abstract

Background: Although hyperuricemia and hypertension are significantly correlated, their temporal relationship and whether this relationship is associated with risk of cardiovascular disease (CVD) are largely unknown. This study aimed to examine temporal relationship between hyperuricemia and hypertension, and its association with future risk of CVD.

Methods: This study included 60,285 participants from the Kailuan study. Measurement of serum uric acid (SUA), systolic and diastolic blood pressure (SBP and DBP) were obtained twice at 2006 (baseline) and 2010. Cross-lagged and mediation analysis were used to examine the temporal relationship between hyperuricemia and hypertension, and the association of this temporal relationship with CVD events risk after 2010.

Results: After adjusting for covariates, the cross-lagged path coefficients (β₁) from baseline SUA to follow-up SBP and DBP were significantly greatly than path coefficients (β₂) from baseline SBP and DBP to follow-up SUA (β₁=0.041 versus β₂=0.003; P_difference<0.0001 for SBP; β₁=0.040 versus β₂=0.000; P_difference<0.0001 for DBP). The path coefficients from baseline SUA to follow-up SBP and DBP in group with incident CVD were significantly greatly than that in group without incident CVD (P_difference of β₁ in the two groups was 0.0018 for SBP and 0.0340 for DBP). Furthermore, SBP and DBP partially mediated the effect of SUA on incident CVD, the mediation effect was 57.64% for SBP and 46.27% for DBP. Similar mediated results were observed for stroke and myocardial infarction.

Conclusion: Increased SUA levels probably precede elevated BP, and BP partially mediates the pathway from SUA to incident CVD.

Keywords: Blood pressure; Cardiovascular disease; Cross-lagged analysis; Mediation analysis; Serum uric acid.

MeSH terms

Blood Pressure
Cardiovascular Diseases* / epidemiology
Humans
Hypertension* / epidemiology
Hyperuricemia* / complications
Hyperuricemia* / epidemiology
Risk Factors
Uric Acid

Substances

Uric Acid