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高尿酸血症与心血管疾病结局风险:URRAH(尿酸有益心脏健康)项目的经验

Hyperuricemia and Risk of Cardiovascular Outcomes: The Experience of the URRAH (Uric Acid Right for Heart Health) Project.

作者信息

Maloberti Alessandro, Giannattasio C, Bombelli M, Desideri G, Cicero A F G, Muiesan M L, Rosei E A, Salvetti M, Ungar A, Rivasi G, Pontremoli R, Viazzi F, Facchetti R, Ferri C, Bernardino B, Galletti F, D'Elia L, Palatini P, Casiglia E, Tikhonoff V, Barbagallo C M, Verdecchia P, Masi S, Mallamaci F, Cirillo M, Rattazzi M, Pauletto P, Cirillo P, Gesualdo L, Mazza A, Volpe M, Tocci G, Iaccarino G, Nazzaro P, Lippa L, Parati G, Dell'Oro R, Quarti-Trevano F, Grassi G, Virdis A, Borghi C

机构信息

Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20159, Milan, Italy.

Health Science Department, Milano-Bicocca University, Milan, Italy.

出版信息

High Blood Press Cardiovasc Prev. 2020 Apr;27(2):121-128. doi: 10.1007/s40292-020-00368-z. Epub 2020 Mar 10.

Abstract

The latest European Guidelines of Arterial Hypertension have officially introduced uric acid evaluation among the cardiovascular risk factors that should be evaluated in order to stratify patient's risk. In fact, it has been extensively evaluated and demonstrated to be an independent predictor not only of all-cause and cardiovascular mortality, but also of myocardial infraction, stroke and heart failure. Despite the large number of studies on this topic, an important open question that still need to be answered is the identification of a cardiovascular uric acid cut-off value. The actual hyperuricemia cut-off (> 6 mg/dL in women and 7 mg/dL in men) is principally based on the saturation point of uric acid but previous evidence suggests that the negative impact of cardiovascular system could occur also at lower levels. In this context, the Working Group on uric acid and CV risk of the Italian Society of Hypertension has designed the Uric acid Right for heArt Health project. The primary objective of this project is to define the level of uricemia above which the independent risk of CV disease may increase in a significantly manner. In this review we will summarize the first results obtained and describe the further planned analysis.

摘要

最新的欧洲动脉高血压指南已正式将尿酸评估纳入应评估的心血管危险因素之中,以便对患者风险进行分层。事实上,尿酸已得到广泛评估,并被证明不仅是全因死亡率和心血管死亡率的独立预测因子,也是心肌梗死、中风和心力衰竭的独立预测因子。尽管针对该主题已有大量研究,但一个仍需回答的重要开放性问题是确定心血管尿酸临界值。实际的高尿酸血症临界值(女性>6mg/dL,男性>7mg/dL)主要基于尿酸的饱和点,但先前的证据表明,心血管系统的负面影响在较低水平时也可能出现。在此背景下,意大利高血压学会尿酸与心血管风险工作组设计了“心脏健康尿酸适宜值”项目。该项目的主要目标是确定血尿酸水平,高于此水平时心血管疾病独立风险可能会显著增加。在本综述中,我们将总结已获得的初步结果,并描述进一步计划的分析。

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