Background Postmenopausal women tend to have hyperuricemia, often co-existing with hypertension. Increased serum uric acid has also been linked with thiazide treatment. Hormone replacement therapy (HRT) may prevent hyperuricemia during thiazide treatment in hypertensive women. The aim of the study was to evaluate whether HRT affects serum uric acid level and its renal excretion in postmenopausal hypertensive women and prevents thiazide induced hyperuricemia.
Material and methods Fifty four hypertensive postmenopausal women aged 58.4 ± 5.1 years, receiving HRT (n = 24) or without HRT (n = 30) were compared with 30 normotensive postmenopausal women. All hypertensive patients were treated with thiazide diuretic. The creatinine and uric acid serum level and renal excretion were estimated after 4–6 months of treatment. Based on this data uric acid clearance and its fractional excretion were calculated.
Results The serum uric acid levels in women without HRT were significantly higher and uric acid clearance and fractional excretion significantly lower than in other groups. Negative correlations between serum uric acid levels and its clearance have been found in all groups. Chronic thiazide therapy of hypertension did not alter serum uric acid concentrations and its renal excretion only in HRT group, whereas in women without HRT serum uric acid levels increased significantly from 6.01 ± 1.21 to 7.12 ± 1.43 mg/dl and both uric acid clearance and its fractional excretion decreased significantly from 8.41 ± 1.89 to 6.57 ± 1.73 ml/min and from 8.02 ± 2.15 to 6.23 ± 1.88% respectively.
Conclusions 1. Both hypertension and menopause had influence on uric acid renal excretion and its serum concentration. 2. Hormone replacement therapy decreases plasma uric acid in postmenopausal women. 3. Hormone replacement therapy tends to prevent hyperuricemia during thiazide treatment of hypertension.