Bombelli Michele, Ronchi Irene, Volpe Marco, Facchetti Rita, Carugo Stefano, Dell'oro Raffaella, Cuspidi Cesare, Grassi Guido, Mancia Giuseppe
aClinica Medica, Dipartimento di Scienze della Salute, Università Milano-Bicocca, Monza, Monza e Brianza bCentro Interuniversitario di Fisiologia Clinica ed Ipertensione - Università Milano-Bicocca, Milano e Pavia, Milan cIstituto Auxologico Italiano, Milan dIRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
J Hypertens. 2014 Jun;32(6):1237-44. doi: 10.1097/HJH.0000000000000161.
Serum uric acid (SUA) has been associated with an increased cardiovascular risk, but no conclusive evidence exists on whether it is an independent risk factor or a reflection of other risk factors to which it is related. We examined the relationship of SUA with a number of cardiovascular variables [including risk factors never evaluated before, such as organ damage and out-of-office blood pressure (BP)], as well as its prognostic relevance in the population.
In 2045 participants of the Pressioni Arteriose Monitorate E Loro Associazioni study, we measured, along with SUA, metabolic, renal, and anthropometric variables, left-ventricular mass index, and office, home and ambulatory BP. Cardiovascular and all-cause mortality was assessed over a 16-year follow-up period, and measurements were repeated 10 years after the initial data collection.
Baseline SUA had a near-normal distribution, with a mean value of 4.9 ± 1.3 (SD) mg/dl and a significant direct relationship with BP and metabolic variables, serum creatinine and left-ventricular mass index. It was among the factors independently predicting new-onset home and ambulatory hypertension, the increased risk of developing these conditions for 1 mg/dl increase of SUA after adjustment for all available potential confounders being 34 and 29%, respectively (P = 0.015 and P = 0.014). An increase in SUA of 1 mg/dl also independently predicted cardiovascular and all-cause mortality, the fully adjusted increase in risk being 22% (P = 0.03) and 12% (P = 0.04), respectively.
In the general population of the Pressioni Arteriose Monitorate E Loro Associazioni study, SUA correlated with a number of cardiovascular risk factors. Nevertheless, it independently predicts new-onset out-of-office hypertension, and long-term cardiovascular and all-cause mortality.
血清尿酸（SUA）与心血管疾病风险增加相关，但尚无确凿证据表明它是一个独立的风险因素，还是与它相关的其他风险因素的一种反映。我们研究了SUA与一系列心血管变量（包括以前从未评估过的风险因素，如器官损害和诊室外血压（BP））之间的关系，以及它在人群中的预后相关性。
在动脉血压监测及其相关性研究的2045名参与者中，我们除了测量SUA外，还测量了代谢、肾脏和人体测量学变量、左心室质量指数以及诊室、家庭和动态血压。在16年的随访期内评估心血管疾病和全因死亡率，并在初始数据收集10年后重复测量。
基线SUA呈近似正态分布，平均值为4.9±1.3（标准差）mg/dl，与血压、代谢变量、血清肌酐和左心室质量指数呈显著正相关。它是独立预测新发家庭和动态高血压的因素之一，在对所有可用的潜在混杂因素进行调整后，SUA每升高1 mg/dl，发生这些情况的风险分别增加34%和29%（P = 0.015和P = 0.014）。SUA每升高1 mg/dl也独立预测心血管疾病和全因死亡率，风险的完全调整后增加分别为22%（P = 0.03）和12%（P = 0.04）。
在动脉血压监测及其相关性研究的一般人群中，SUA与多种心血管风险因素相关。然而，它独立预测新发诊室外高血压以及长期心血管疾病和全因死亡率。
