open access

Vol 26, No 3 (2019)
Original articles — Clinical cardiology
Published online: 2019-06-05
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Study of epidemiological aspects of hyperuricemia in Poland

Katarzyna Kostka-Jeziorny, Krystyna Widecka, Andrzej Tykarski
DOI: 10.5603/CJ.a2019.0034
·
Pubmed: 31225633
·
Cardiol J 2019;26(3):241-252.

open access

Vol 26, No 3 (2019)
Original articles — Clinical cardiology
Published online: 2019-06-05

Abstract

Background: The results of the latest epidemiological studies show that the problem of hyperuricemia affects many millions of people. The main purpose of the study was to assess the knowledge of physicians with regard to the epidemiology and treatment of hyperuricemia in Poland.

Methods: CAPI (computer assisted personal interview) interviews were conducted using short questionnaires among primary health care physicians, cardiologists and diabetologists. The entire questionnaire included 11 questions. Questions were asked to physicians at 5 different periods in time. The number of physicians surveyed, depended on the time period, and ranged from 8663 to 9980. 

Results: Only every 1 in 7 physicians (14%) considered that hyperuricemia in patients with cardiovascular risk factors begins when the uric acid level is 5 mg/dL, thus in line with the expert recommendations. 72% of respondents asked to indicate the uric acid levels they consider to be indicative of hyperuricemia in patients in the cardiovascular risk group, gave values ranging from 6 to 7 mg/dL, namely the values justified in cases of a patient without such a risk, i.e. in the general population. 86% of doctors surveyed gave values different from that recommended by experts. 

Conclusions: The findings of the questionnaire in this survey suggests that doctors often underestimate the problem of hyperuricemia in patients with a high risk of cardiovascular disease. An important step towards more effective therapy of hyperuricemia in routine clinical practice is to raise the awareness of hyperuricemia and its comorbidities both among doctors and patients and encourage monitoring and treatment.

Abstract

Background: The results of the latest epidemiological studies show that the problem of hyperuricemia affects many millions of people. The main purpose of the study was to assess the knowledge of physicians with regard to the epidemiology and treatment of hyperuricemia in Poland.

Methods: CAPI (computer assisted personal interview) interviews were conducted using short questionnaires among primary health care physicians, cardiologists and diabetologists. The entire questionnaire included 11 questions. Questions were asked to physicians at 5 different periods in time. The number of physicians surveyed, depended on the time period, and ranged from 8663 to 9980. 

Results: Only every 1 in 7 physicians (14%) considered that hyperuricemia in patients with cardiovascular risk factors begins when the uric acid level is 5 mg/dL, thus in line with the expert recommendations. 72% of respondents asked to indicate the uric acid levels they consider to be indicative of hyperuricemia in patients in the cardiovascular risk group, gave values ranging from 6 to 7 mg/dL, namely the values justified in cases of a patient without such a risk, i.e. in the general population. 86% of doctors surveyed gave values different from that recommended by experts. 

Conclusions: The findings of the questionnaire in this survey suggests that doctors often underestimate the problem of hyperuricemia in patients with a high risk of cardiovascular disease. An important step towards more effective therapy of hyperuricemia in routine clinical practice is to raise the awareness of hyperuricemia and its comorbidities both among doctors and patients and encourage monitoring and treatment.

Get Citation

Keywords

hyperuricemia; arterial hypertension

About this article
Title

Study of epidemiological aspects of hyperuricemia in Poland

Journal

Cardiology Journal

Issue

Vol 26, No 3 (2019)

Pages

241-252

Published online

2019-06-05

DOI

10.5603/CJ.a2019.0034

Pubmed

31225633

Bibliographic record

Cardiol J 2019;26(3):241-252.

Keywords

hyperuricemia
arterial hypertension

Authors

Katarzyna Kostka-Jeziorny
Krystyna Widecka
Andrzej Tykarski

References (42)
  1. Freedman DS, Williamson DF, Gunter EW, et al. Relation of serum uric acid to mortality and ischemic heart disease. The NHANES I Epidemiologic Follow-up Study. Am J Epidemiol. 1995; 141(7): 637–644.
  2. Smith E, Hoy D, Cross M, et al. The global burden of gout: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014; 73(8): 1470–1476.
  3. Roddy E, Choi HK. Epidemiology of gout. Rheum Dis Clin North Am. 2014; 40(2): 155–175.
  4. Culleton B, Larson M, Kannel W, et al. Serum Uric Acid and Risk for Cardiovascular Disease and Death: The Framingham Heart Study. Ann Intern Med. 1999; 131(1): 7–13.
  5. Ostrander LD, Lamphiear DE. Coronary risk factors in a community. Findings in Tecumseh, Michigan. Circulation. 1976; 53(1): 152–156.
  6. Tykarski A, Narkiewicz K, Gaciong Z, et al. 2015 guidelines for the management of hypertension. Recommendations of the Polish Society of Hypertension - short version. Kardiol Pol. 2015; 73(8): 676–700.
  7. Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39(33): 3021–3104.
  8. Widecka K, Szymański FM, Filipiak KJ, et al. Stanowisko ekspertów dotyczące hiperurykemii i jej leczenia u pacjentów z wysokim ryzykiem sercowo-naczyniowym. Arterial Hypertens. 2017; 21(1): 1–9.
  9. Borghi C, Tykarski A, Widecka K, et al. Expert consensus for the diagnosis and treatment of patient with hyperuricemia and high cardiovascular risk. Cardiol J. 2018; 25(5): 545–563.
  10. Bombelli M, Toso E, Peronio M, et al. The Pamela study: main findings and perspectives. Curr Hypertens Rep. 2013; 15(3): 238–243.
  11. Beck L. Clinical disorders of uric acid metabolism. Med Clin North Am. 1981; 65(2): 401–411.
  12. Cannon PJ, Stason WB, Demartini FE, et al. Hyperuricemia in primary and renal hypertension. N Engl J Med. 1966; 275(9): 457–464.
  13. Ford ES, Li C, Cook S, et al. Serum concentrations of uric acid and the metabolic syndrome among US children and adolescents. Circulation. 2007; 115(19): 2526–2532.
  14. Puig JG, Martínez MA. Hyperuricemia, gout and the metabolic syndrome. Curr Opin Rheumatol. 2008; 20(2): 187–191.
  15. Tuttle KR, Short RA, Johnson RJ. Sex differences in uric acid and risk factors for coronary artery disease. Am J Cardiol. 2001; 87(12): 1411–1414.
  16. Dehghan A, van Hoek M, Sijbrands EJG, et al. High serum uric acid as a novel risk factor for type 2 diabetes. Diabetes Care. 2008; 31(2): 361–362.
  17. Schretlen DJ, Inscore AB, Vannorsdall TD, et al. Serum uric acid and brain ischemia in normal elderly adults. Neurology. 2007; 69(14): 1418–1423.
  18. Lehto S, Niskanen L, Rönnemaa T, et al. Serum uric acid is a strong predictor of stroke in patients with non-insulin-dependent diabetes mellitus. Stroke. 1998; 29(3): 635–639.
  19. Yu KH, Kuo CF, Luo SF, et al. Risk of end-stage renal disease associated with gout: a nationwide population study. Arthritis Res Ther. 2012; 14(2): R83.
  20. Abbott RD, Brand FN, Kannel WB, et al. Gout and coronary heart disease: the Framingham Study. J Clin Epidemiol. 1988; 41(3): 237–242.
  21. De Vera MA, Rahman MM, Bhole V, et al. Independent impact of gout on the risk of acute myocardial infarction among elderly women: a population-based study. Ann Rheum Dis. 2010; 69(6): 1162–1164.
  22. Watanabe S, Kang DH, Feng L, et al. Uric acid, hominoid evolution, and the pathogenesis of salt-sensitivity. Hypertension. 2002; 40(3): 355–360.
  23. Lin C, Zhang Pu, Xue Y, et al. Link of renal microcirculatory dysfunction to increased coronary microcirculatory resistance in hypertensive patients. Cardiol J. 2017; 24(6): 623–632.
  24. Krishnan E, Kwoh CK, Schumacher HR, et al. Hyperuricemia and incidence of hypertension among men without metabolic syndrome. Hypertension. 2007; 49(2): 298–303.
  25. Mellen PB, Bleyer AJ, Erlinger TP, et al. Serum uric acid predicts incident hypertension in a biethnic cohort: the atherosclerosis risk in communities study. Hypertension. 2006; 48(6): 1037–1042.
  26. Furukawa S, Fujita T, Shimabukuro M, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest. 2004; 114(12): 1752–1761.
  27. Fabbrini E, Serafini M, Colic Baric I, et al. Effect of plasma uric acid on antioxidant capacity, oxidative stress, and insulin sensitivity in obese subjects. Diabetes. 2014; 63(3): 976–981.
  28. Prasad M, Matteson EL, Herrmann J, et al. Uric acid is associated with inflammation, coronary microvascular dysfunction, and adverse outcomes in postmenopausal women. Hypertension. 2017; 69(2): 236–242.
  29. Farquharson C, Butler R, Hill A, et al. Allopurinol improves endothelial dysfunction in chronic heart failure. Circulation. 2002; 106(2): 221–226.
  30. Bickel C, Rupprecht H, Blankenberg S, et al. Serum uric acid as an independent predictor of mortality in patients with angiographically proven coronary artery disease. Am J Cardiol. 2002; 89(1): 12–17.
  31. Wong KYK, MacWalter RS, Fraser HW, et al. Urate predicts subsequent cardiac death in stroke survivors. Eur Heart J. 2002; 23(10): 788–793.
  32. Hare J, Johnson R. Uric acid predicts clinical outcomes in heart failure. Circulation. 2003; 107(15): 1951–1953.
  33. Feig DI, Johnson RJ. Hyperuricemia in childhood primary hypertension. Hypertension. 2003; 42(3): 247–252.
  34. Richette P, Doherty M, Pascual E, et al. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2017; 76(1): 29–42.
  35. Stamp LK, O'Donnell JL, Zhang M, et al. Using allopurinol above the dose based on creatinine clearance is effective and safe in patients with chronic gout, including those with renal impairment. Arthritis Rheum. 2011; 63(2): 412–421.
  36. Rees F, Jenkins W, Doherty M. Patients with gout adhere to curative treatment if informed appropriately: proof-of-concept observational study. Ann Rheum Dis. 2013; 72(6): 826–830.
  37. Ramasamy SN, Korb-Wells CS, Kannangara DRW, et al. Allopurinol hypersensitivity: a systematic review of all published cases, 1950-2012. Drug Saf. 2013; 36(10): 953–980.
  38. Hershfield MS, Callaghan JT, Tassaneeyakul W, et al. Clinical pharmacogenetics implementation consortium guidelines for human leukocyte antigen-B genotype and allopurinol dosing. Clin Pharmacol Ther. 2013; 93(2): 153–158.
  39. Hande KR, Noone RM, Stone WJ. Severe allopurinol toxicity. Description and guidelines for prevention in patients with renal insufficiency. Am J Med. 1984; 76(1): 47–56.
  40. Krishnan E, Pandya BJ, Lingala B, et al. Hyperuricemia and untreated gout are poor prognostic markers among those with a recent acute myocardial infarction. Arthritis Res Ther. 2012; 14(1): R10.
  41. Bos MJ, Koudstaal PJ, Hofman A, et al. Uric acid is a risk factor for myocardial infarction and stroke: the Rotterdam study. Stroke. 2006; 37(6): 1503–1507.
  42. Ndrepepa G, Braun S, Haase HU, et al. Prognostic value of uric acid in patients with acute coronary syndromes. Am J Cardiol. 2012; 109(9): 1260–1265.

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