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台湾地区高血压患者高尿酸血症的流行情况及其与降压治疗的关系。

Prevalence of hyperuricemia and its association with antihypertensive treatment in hypertensive patients in Taiwan.

机构信息

Department of Internal Medicine, Chung Shan Medical University Hospital and School of Medicine, Chung Shan Medical University, Taichung, Taiwan.

出版信息

Int J Cardiol. 2012 Apr 5;156(1):41-6. doi: 10.1016/j.ijcard.2010.10.033. Epub 2010 Nov 20.

Abstract

BACKGROUND

Hyperuricemia is thought to be associated with an increased risk of hypertension, impaired renal function and cardiovascular disease. Our aim is to study the prevalence of hyperuricemia and its association with antihypertensive treatment in Taiwanese hypertensive subjects.

METHODS

We recruited 2145 hypertensive subjects from 19 hospitals in four areas of Taiwan. We assessed the prevalence of hyperuricemia and determined the independent risk factors for raised serum uric acid level by multiple logistic regression analyses.

RESULTS

Compared to the general population, hypertensive subjects in Taiwan had a higher prevalence (mean 35% in males, 43% in females) of hyperuricemia; this prevalence being 1.5- and 1.7-fold higher in males and females respectively. Uric acid levels; gout and prevalence of hyperuricemia were found to be highest in the younger age group (20-39 years) and no regional differences were noted. The most important risk factors for hyperuricemia were impaired renal function and diuretic use. Serum uric acid values correlated significantly with four quintiles of serum creatinine (p<0.0001) independent of diuretic use. Diuretic users had a significantly elevated serum uric acid and serum creatinine values than non-users. Among the patients given diuretics, hyperuricemia occurred in 44% of those given thiazides, in 56% of those given loop diuretics, and in 57% of those given aldosterone receptor blockers.

CONCLUSIONS

Diuretic usage and renal function status have a strong impact on the prevalence of hyperuricemia in Taiwanese hypertensive subjects. It is still unclear, however, whether diuretics induce renal failure through elevating serum uric acid levels.

摘要

背景

高尿酸血症被认为与高血压、肾功能损害和心血管疾病风险增加有关。我们的目的是研究台湾高血压患者高尿酸血症的患病率及其与降压治疗的关系。

方法

我们从台湾四个地区的 19 家医院招募了 2145 名高血压患者。我们评估了高尿酸血症的患病率,并通过多因素逻辑回归分析确定了血清尿酸水平升高的独立危险因素。

结果

与一般人群相比,台湾高血压患者的高尿酸血症患病率较高(男性为 35%,女性为 43%);男性和女性的患病率分别高 1.5 倍和 1.7 倍。尿酸水平、痛风和高尿酸血症的患病率在年龄较小的组(20-39 岁)最高,且无地域差异。高尿酸血症最重要的危险因素是肾功能不全和利尿剂的使用。血清尿酸值与血清肌酐的四个五分位数显著相关(p<0.0001),与利尿剂的使用无关。与非利尿剂使用者相比,利尿剂使用者的血清尿酸和肌酐值显著升高。在使用利尿剂的患者中,噻嗪类利尿剂使用者中有 44%发生高尿酸血症,袢利尿剂使用者中有 56%发生高尿酸血症,醛固酮受体拮抗剂使用者中有 57%发生高尿酸血症。

结论

利尿剂的使用和肾功能状态对台湾高血压患者高尿酸血症的患病率有很大影响。然而,利尿剂是否通过升高血清尿酸水平导致肾功能衰竭仍不清楚。

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