open access

Vol 9, No 1 (2014)
Original Papers
Published online: 2014-03-18
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Clinical importance of hyperuricaemia in hospitalised hypertensive patients

Katarzyna Dziubek, Paweł Salwa, Iwona Gorczyca-Michta, Ewa Tomasik, Elżbieta Jaskulska-Niedziela, Kamil Michta, Beata Wożakowska-Kapłon
Folia Cardiologica 2014;9(1):1-7.

open access

Vol 9, No 1 (2014)
Original Papers
Published online: 2014-03-18

Abstract

Introduction. Multiple clinical studies showed an association between hyperuricaemia (HU) and cardiovascular disease, hypertension, chronic kidney disease, and metabolic syndrome. It has been debated for many years whether HU is an independent risk factor for cardiovascular disease or just a condition commonly coexisting with conventional risk factors. Despite many reports, the importance of HU in the pathogenesis of cardiovascular disease has not been clearly established.

Aim of the study was to evaluate the prevalence of HU in patients with hypertension and to compare groups of treated hypertensive patients with normal or elevated serum uric acid level.

Material and methods. We retrospectively analyzed consecutive hypertensive patients hospitalized in a tertiary carecardiology centre in 2009–2010. We analyzed clinical data with particular reference to concomitant diseases, previous myocardial infarction and stroke, heart failure, biochemical parameters, and selected echocardiographic parameters in groups of patients with normal or elevated serum uric acid level.

Results. We analyzed 2076 patients including 1148 men (55.3%) and 928 women (44.7%). Normouricaemia (NU) was found in 1423 patients (68.5%) and HU in 653 patients (31.4%). Mean age was 67.7 ± 11 years in the NU group and 70.1 ± 10 years in the HU group. The NU group included 771 men (54.2%) and 652 women (45.8%). The HU group included 377 men (57.7%) and 276 women (42.3%). The prevalence of concomitant conditions in the NU and HU groups was as follows: type 2 diabetes — 24.4% vs. 29.7%, respectively (p = 0.0545), ischaemic heart disease — 27.5% vs. 35.1% (p = 0.1000), previous myocardial infarction — 8.3% vs. 12.7% (p = 0.0044), previous stroke — 4.7% vs. 5.0% (p = 0.7453), atrial fibrillation — 25.8% vs. 40.1% (p = 0.0001), New York Heart Association (NYHA) class II heart failure— 20.5% vs. 22.7% (p = 0.3700), NYHA class III heart failure — 11.0% vs. 22.5% (p = 0.0004), NYHA class IV heart failure— 1.3% vs. 5.3% (p = 0.0001), glomerular filtration rate < 60 mL/min — 39.6% vs. 66.3% (p < 0.0001), left ventricular hypertrophy — 36.3% vs. 40.1% (p = 0.2800), left ventricular ejection fraction ≥ 50% — 61.2% vs. 55.4% (p = 0.4200), left ventricular ejection fraction 36–49%: 24.2% vs. 21.1% (p = 0.2600), left ventricular ejection fraction ≤ 35%; 14.5% vs. 27.6% (p < 0.0001), hypercholesterolaemia — 37.1% vs. 40.6% (p = 0.3200), hypertriglicerydaemia — 15.4% vs. 14.1% (p = 0.5200), mixed dyslipidaemia — 15.2% vs. 19.2% (p = 0.0339), atherogenic dyslipidaemia in men — 18.1% vs. 20.2% (p = 0.5000), atherogenic dyslipidaemia in women — 15.0% vs. 24.1% (p = 0.0074).

Conclusions

1. Among hospitalised hypertensive patients, those with HU more often showed advanced heart failure, atrial fibrillation, impaired renal function, mixed dyslipidaemia, and atherogenic dyslipidaemia in women when compared to hypertensives with normal uric acid level.

2. Among hospitalised hypertensive patients, HU was more frequent among patients above 55 years of age compared to younger patients.

3. Further studies are necessary to determine the importance of HU and benefits from reduction of uric acid level inpatients with hypertension.

Abstract

Introduction. Multiple clinical studies showed an association between hyperuricaemia (HU) and cardiovascular disease, hypertension, chronic kidney disease, and metabolic syndrome. It has been debated for many years whether HU is an independent risk factor for cardiovascular disease or just a condition commonly coexisting with conventional risk factors. Despite many reports, the importance of HU in the pathogenesis of cardiovascular disease has not been clearly established.

Aim of the study was to evaluate the prevalence of HU in patients with hypertension and to compare groups of treated hypertensive patients with normal or elevated serum uric acid level.

Material and methods. We retrospectively analyzed consecutive hypertensive patients hospitalized in a tertiary carecardiology centre in 2009–2010. We analyzed clinical data with particular reference to concomitant diseases, previous myocardial infarction and stroke, heart failure, biochemical parameters, and selected echocardiographic parameters in groups of patients with normal or elevated serum uric acid level.

Results. We analyzed 2076 patients including 1148 men (55.3%) and 928 women (44.7%). Normouricaemia (NU) was found in 1423 patients (68.5%) and HU in 653 patients (31.4%). Mean age was 67.7 ± 11 years in the NU group and 70.1 ± 10 years in the HU group. The NU group included 771 men (54.2%) and 652 women (45.8%). The HU group included 377 men (57.7%) and 276 women (42.3%). The prevalence of concomitant conditions in the NU and HU groups was as follows: type 2 diabetes — 24.4% vs. 29.7%, respectively (p = 0.0545), ischaemic heart disease — 27.5% vs. 35.1% (p = 0.1000), previous myocardial infarction — 8.3% vs. 12.7% (p = 0.0044), previous stroke — 4.7% vs. 5.0% (p = 0.7453), atrial fibrillation — 25.8% vs. 40.1% (p = 0.0001), New York Heart Association (NYHA) class II heart failure— 20.5% vs. 22.7% (p = 0.3700), NYHA class III heart failure — 11.0% vs. 22.5% (p = 0.0004), NYHA class IV heart failure— 1.3% vs. 5.3% (p = 0.0001), glomerular filtration rate < 60 mL/min — 39.6% vs. 66.3% (p < 0.0001), left ventricular hypertrophy — 36.3% vs. 40.1% (p = 0.2800), left ventricular ejection fraction ≥ 50% — 61.2% vs. 55.4% (p = 0.4200), left ventricular ejection fraction 36–49%: 24.2% vs. 21.1% (p = 0.2600), left ventricular ejection fraction ≤ 35%; 14.5% vs. 27.6% (p < 0.0001), hypercholesterolaemia — 37.1% vs. 40.6% (p = 0.3200), hypertriglicerydaemia — 15.4% vs. 14.1% (p = 0.5200), mixed dyslipidaemia — 15.2% vs. 19.2% (p = 0.0339), atherogenic dyslipidaemia in men — 18.1% vs. 20.2% (p = 0.5000), atherogenic dyslipidaemia in women — 15.0% vs. 24.1% (p = 0.0074).

Conclusions

1. Among hospitalised hypertensive patients, those with HU more often showed advanced heart failure, atrial fibrillation, impaired renal function, mixed dyslipidaemia, and atherogenic dyslipidaemia in women when compared to hypertensives with normal uric acid level.

2. Among hospitalised hypertensive patients, HU was more frequent among patients above 55 years of age compared to younger patients.

3. Further studies are necessary to determine the importance of HU and benefits from reduction of uric acid level inpatients with hypertension.

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Keywords

hyperuricaemia, uric acid, hypertension

About this article
Title

Clinical importance of hyperuricaemia in hospitalised hypertensive patients

Journal

Folia Cardiologica

Issue

Vol 9, No 1 (2014)

Pages

1-7

Published online

2014-03-18

Bibliographic record

Folia Cardiologica 2014;9(1):1-7.

Keywords

hyperuricaemia
uric acid
hypertension

Authors

Katarzyna Dziubek
Paweł Salwa
Iwona Gorczyca-Michta
Ewa Tomasik
Elżbieta Jaskulska-Niedziela
Kamil Michta
Beata Wożakowska-Kapłon

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