From the Department of Cardiology and Division of Preemptive Medicine for Vascular Damage, Tokyo Medical University, Japan (H.T., K.S., Y.I., C.M., K.K., M.F., T.C., A.Y.).
1st Cardiology Department, Athens Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Greece (C.V.).
Hypertension. 2018 Sep;72(3):739-745. doi: 10.1161/HYPERTENSIONAHA.118.11390.
This study analyzed repeated measurement data to clarify the longitudinal associations between hyperuricemia and the risk factors for the development of hypertension (ie, increased arterial stiffness, renal dysfunction, and inflammation), and then examined whether these risk factors show longitudinal associations with the development of hypertension. In 3274 Japanese men without hypertension, the brachial-ankle pulse wave velocity, blood pressure, estimated glomerular filtration rate, and serum uric acid and CRP (C-reactive protein) levels were measured annually over an 8-year period. Of these, 474 subjects developed hypertension by the end of the study period. Mixed model linear regression analysis revealed a significant longitudinal association of hyperuricemia with increase of the brachial-ankle pulse wave velocity (estimate=5.50, P=0.04), decrease of the estimated glomerular filtration rate (estimate=-2.02, P<0.01), and elevation of the CRP (estimate=0.08×10, P=0.02). Hyperuricemia at the study baseline was associated with a significant odds ratio for the development of hypertension by the end of the study period. After adjustments for covariates, the brachial-ankle pulse wave velocity (estimate=0.51×10, P<0.01) and CRP (estimate=1.91, P=0.03), but not estimated glomerular filtration rate, were found to show independent longitudinal associations with the new onset of hypertension. In Japanese men without hypertension, hyperuricemia may have a longitudinal association with the development of hypertension, and increased arterials stiffness and inflammation may be involved in the risk of development of hypertension associated with hyperuricemia.
本研究分析了重复测量数据，以阐明高尿酸血症与高血压发展的危险因素（即动脉僵硬增加、肾功能障碍和炎症）之间的纵向关联，然后检查这些危险因素是否与高血压的发展具有纵向关联。在 3274 名没有高血压的日本男性中，在 8 年期间每年测量一次肱踝脉搏波速度、血压、估计肾小球滤过率以及血清尿酸和 CRP（C 反应蛋白）水平。其中，474 名受试者在研究期末发展为高血压。混合模型线性回归分析显示，高尿酸血症与肱踝脉搏波速度增加（估计值=5.50，P=0.04）、估计肾小球滤过率降低（估计值=-2.02，P<0.01）和 CRP 升高（估计值=0.08×10，P=0.02）呈显著的纵向关联。研究基线时的高尿酸血症与研究期末高血压的发生有显著的比值比相关。在调整了协变量后，肱踝脉搏波速度（估计值=0.51×10，P<0.01）和 CRP（估计值=1.91，P=0.03），而不是估计肾小球滤过率，与高血压的新发呈独立的纵向关联。在没有高血压的日本男性中，高尿酸血症可能与高血压的发展具有纵向关联，并且动脉僵硬增加和炎症可能与高尿酸血症相关的高血压发展风险有关。
