Krishnan Eswar, Kwoh C Kent, Schumacher H Ralph, Kuller Lewis
School of Medicine, University of Pittsburgh, Pittsburgh, Pa., USA.
Hypertension. 2007 Feb;49(2):298-303. doi: 10.1161/01.HYP.0000254480.64564.b6. Epub 2006 Dec 26.
The aim of this project was to study the risk of developing hypertension over a 6-year follow-up in normotensive men with baseline hyperuricemia (serum uric acid >7.0 mg/dL) but without diabetes/glucose intolerance or metabolic syndrome. We analyzed the data on men without metabolic syndrome or hypertension at baseline from the Multiple Risk Factor Intervention Trial. These men (n=3073; age: 35 to 57 years) were followed for an average of 6 years by annual examinations. Follow-up blood pressure among those with baseline was consistently higher than among those with normal serum uric acid concentration. We used Cox regression models for adjustment for the effects of serum creatinine, body mass index, age, blood pressure, proteinuria, serum cholesterol and triglycerides, alcohol and tobacco use, risk factor interventions, and use of diuretics. In these models, normotensive men with baseline hyperuricemia had an 80% excess risk for incident hypertension (hazard ratio: 1.81; 95% CI: 1.59 to 2.07) compared with those who did not. Each unit increase in serum uric acid was associated with a 9% increase in the risk for incident hypertension (hazard ratio: 1.09; 95% CI: 1.02 to 1.17). We conclude that the hyperuricemia-hypertension risk relationship is present among normotensive middle-aged men without diabetes/glucose intolerance or metabolic syndrome.
本项目的目的是研究基线血尿酸水平升高(血清尿酸>7.0mg/dL)但无糖尿病/糖耐量异常或代谢综合征的血压正常男性在6年随访期间发生高血压的风险。我们分析了多重危险因素干预试验中基线时无代谢综合征或高血压的男性的数据。这些男性(n=3073;年龄:35至57岁)通过年度检查平均随访6年。基线血尿酸水平升高者的随访血压始终高于血清尿酸浓度正常者。我们使用Cox回归模型来调整血清肌酐、体重指数、年龄、血压、蛋白尿、血清胆固醇和甘油三酯、饮酒和吸烟、危险因素干预以及利尿剂使用的影响。在这些模型中,与无基线血尿酸水平升高的血压正常男性相比,基线血尿酸水平升高的血压正常男性发生高血压的额外风险高80%(风险比:1.81;95%CI:1.59至2.07)。血清尿酸每升高一个单位,发生高血压的风险增加9%(风险比:1.09;95%CI:1.02至1.17)。我们得出结论,在无糖尿病/糖耐量异常或代谢综合征的血压正常中年男性中存在高尿酸血症与高血压的风险关系。