Ofori Sandra N, Odia Osaretin J
Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
Vasc Health Risk Manag. 2014 May 2;10:253-61. doi: 10.2147/VHRM.S61363. eCollection 2014.
Hypertension is a major risk factor for cardiovascular mortality, as it acts through its effects on target organs, such as the heart and kidneys. Hyperuricemia increases cardiovascular risk in patients with hypertension.
To assess the relationship between serum uric acid and target organ damage (left ventricular hypertrophy and microalbuminuria) in untreated patients with essential hypertension.
A cross-sectional study was carried out in 130 (85 females, 45 males) newly diagnosed, untreated patients with essential hypertension. Sixty-five healthy age- and sex-matched non-hypertensive individuals served as controls for comparison. Left ventricular hypertrophy was evaluated by cardiac ultrasound scan, and microalbuminuria was assessed in an early morning midstream urine sample by immunoturbidimetry. Blood samples were collected for assessing uric acid levels.
Mean serum uric acid was significantly higher among the patients with hypertension (379.7±109.2 μmol/L) than in the controls (296.9±89.8 μmol/L; P<0.001), and the prevalence of hyperuricemia was 46.9% among the hypertensive patients and 16.9% among the controls (P<0.001). Among the hypertensive patients, microalbuminuria was present in 54.1% of those with hyperuricemia and in 24.6% of those with normal uric acid levels (P=0.001). Similarly, left ventricular hypertrophy was more common in the hypertensive patients with hyperuricemia (70.5% versus 42.0%, respectively; P=0.001). There was a significant linear relationship between mean uric acid levels and the number of target organ damage (none versus one versus two: P=0.012).
These results indicate that serum uric acid is associated with target organ damage in patients with hypertension, even at the time of diagnosis; thus, it is a reliable marker of cardiovascular damage in our patient population.
高血压是心血管疾病死亡的主要危险因素，因为它通过对心脏和肾脏等靶器官产生影响而发挥作用。高尿酸血症会增加高血压患者的心血管疾病风险。
评估未经治疗的原发性高血压患者血清尿酸与靶器官损害（左心室肥厚和微量白蛋白尿）之间的关系。
对130例（85例女性，45例男性）新诊断的未经治疗的原发性高血压患者进行了一项横断面研究。65名年龄和性别匹配的健康非高血压个体作为对照进行比较。通过心脏超声扫描评估左心室肥厚情况，并通过免疫比浊法对清晨中段尿样本进行微量白蛋白尿评估。采集血样以评估尿酸水平。
高血压患者的平均血清尿酸（379.7±109.2μmol/L）显著高于对照组（296.9±89.8μmol/L；P<0.001），高血压患者中高尿酸血症的患病率为46.9%，对照组为16.9%（P<0.001）。在高血压患者中，高尿酸血症患者中有54.1%存在微量白蛋白尿，尿酸水平正常者中有24.6%存在微量白蛋白尿（P=0.001）。同样，高尿酸血症的高血压患者左心室肥厚更为常见（分别为70.5%和42.0%；P=0.001）。平均尿酸水平与靶器官损害数量之间存在显著的线性关系（无损害、一处损害、两处损害：P=0.012）。
这些结果表明，即使在诊断时，血清尿酸也与高血压患者的靶器官损害有关；因此，它是我们患者群体中心血管损害的可靠标志物。
