Hypertension Was the Major Risk Factor Leading to Development of Cardiovascular Diseases Among Men with Hyperuricemia

KUAN-CHIA LIN, HSUAN-MING TSAO, CHEN-HUAN CHEN, and PESUS CHOU

ABSTRACT.

Objective. A 7-year followup study among men with hyperuricemia was conducted to study the longterm relationships between serum uric acid concentrations and cardiovascular diseases. Any interaction between uric acid levels and other risk factors (e.g., obesity, hypertension) on the development of cardiovascular diseases was also examined.

Methods. A total of 391 men with hyperuricemia aged 30 and over screened from the community-based Kinmen study in 1991-92 (the baseline study) were followed in 1997-98, with a 75% followup rate. Demographic, clinical, and biochemical data were collected in both baseline and followup periods.

Results. After followup for 7 years, the significant risk factors of coronary heart disease were age, increase of uric acid level at followup, baseline systolic blood pressure, and increase of systolic blood pressure at followup. Factors independently associated with left ventricular hypertrophy included baseline systolic blood pressure and increase of systolic blood pressure at followup. Gouty syndrome, age, baseline fasting plasma glucose level, and increase of systolic blood pressure followup were significantly related to cardiac arrhythmia. After adjusting for baseline serum uric acid level, we found that hyperuricemic men with hypertension, especially overt hypertension stage 2 and stage 3, would predict cardiovascular disease incidence synergistically with uric acid level.

Conclusion. There is a positive and statistically significant relationship between gout and subsequent cardiac arrhythmia. Moreover, hypertension was the major risk factor leading to aggravation of development of atherosclerosis among hyperuricemic subjects. Gout and elevated uric acid level seemed not to be an independent risk factor for most cardiovascular diseases. Nevertheless, blood pressure level was predictive for cardiovascular disease incidence synergistically with serum uric acid level. (J Rheumatol 2004;31:1152-8)

Key Indexing Terms:

HYPERURICEMIA
HYPERTENSION
CARDIOVASCULAR DISEASES

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From the Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.

Supported by grants from the National Science Council, R.O.C. (NSC 89-2314-B-010-061), and the Yen Tjing-Ling Medical Foundation.

K-C. Lin, PhD, Department of Nursing, National Taipei College of Nursing; H-M. Tsao, MD; C-H. Chen, MD, Department of Medicine, Cardiovascular Research Center, Veterans General Hospital–Taipei; P. Chou, DrPH, Community Medicine Research Center and Institute of Public Health, National Yang-Ming University.

Address reprint requests to Dr. P. Chou, National Yang-Ming University, Institute of Public Health, Shih-Pai, Taipei, 11221, Taiwan. E-mail: pschou@ym.edu.tw

Submitted April 28, 2003; revision accepted December 19, 2003.

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