Han Chunli, Xian Zhanchao, Zou Yang, Liao Zhiyong, Yang Rongfeng, Zou Chunxia, Wang Xiaoqing, Sun Yan
Department of Cardiology, the Fifth Subsidiary Sun Yat-sen University Hospital, Zhuhai, China.
Department of Cardiology, Shenzhen Sun Yat-sen Cardiovascular Hospital, Shenzhen, China.
Arch Med Sci. 2019 Mar;15(2):343-349. doi: 10.5114/aoms.2018.73856. Epub 2018 Mar 2.
The aim of the study was to evaluate whether flow-mediated dilation (FMD) can be used to predict incident hypertension in patients with hyperuricemia.
Normotensive participants with and without hyperuricemia at baseline were prospectively enrolled. Flow-mediated dilation was assessed at baseline, and after 1 year's follow-up the incidence of hypertension was compared between those with and without hyperuricemia. The predictive value of baseline FMD for incident hypertension among hyperuricemia patients was evaluated.
A total of 222 participants were included. Mean systolic and diastolic blood pressure (BP) was 129.5 ±8.4 mm Hg and 78.3 ±7.9 mm Hg. Mean serum uric acid (UA) level was 4.4 ±2.8 mg/dl. Mean FMD was 5.1 ±2.7%. Compared to normal UA group, hyperuricemia group had higher proportion of male (58.4% vs. 61.2%), higher systolic BP (125.4 ±7.9 mm Hg vs. 132.1 ±7.3 mm Hg), serum high sensitivity C-reactive protein (3.9 ±2.2 mg/dl vs. 4.5 ±3.0 mg/dl) and UA (3.5 ±1.4 mg/dl vs. 5.7 ±0.7 mg/dl) levels, but lower mean FMD (5.6 ±2.4% vs. 4.8 ±2.0%) ( < 0.05 for all comparisons). No participant in normal UA group developed hypertension, while in hyperuricemia group, 6 participants developed hypertension. In hyperuricemia participants, after adjusted for covariates, per 1-standard deviation decrease in baseline FMD remained significantly associated with 15% increased risk of incident hypertension.
Patients with hyperuricemia have an increased risk of developing hypertension, and low baseline FMD in hyperuricemia patients is associated with significantly increased risk of incident hypertension.
本研究的目的是评估血流介导的血管舒张功能（FMD）是否可用于预测高尿酸血症患者发生高血压的风险。
前瞻性纳入了基线时有无高尿酸血症的血压正常参与者。在基线时评估血流介导的血管舒张功能，并在随访1年后比较有无高尿酸血症者高血压的发生率。评估基线FMD对高尿酸血症患者发生高血压的预测价值。
共纳入222名参与者。平均收缩压和舒张压分别为129.5±8.4 mmHg和78.3±7.9 mmHg。平均血清尿酸（UA）水平为4.4±2.8 mg/dl。平均FMD为5.1±2.7%。与正常尿酸组相比，高尿酸血症组男性比例更高（58.4%对61.2%），收缩压更高（125.4±7.9 mmHg对132.1±7.3 mmHg），血清高敏C反应蛋白水平更高（3.9±2.2 mg/dl对4.5±3.0 mg/dl）以及UA水平更高（3.5±1.4 mg/dl对5.7±0.7 mg/dl），但平均FMD更低（5.6±2.4%对4.8±2.0%）（所有比较P<0.05）。正常尿酸组无参与者发生高血压，而高尿酸血症组有6名参与者发生高血压。在高尿酸血症参与者中，校正协变量后，基线FMD每降低1个标准差仍与发生高血压的风险显著增加15%相关。
高尿酸血症患者发生高血压的风险增加，高尿酸血症患者较低的基线FMD与发生高血压的风险显著增加相关。
