Zeng Fanfang, Huang Rong, Lu Yongkang, Wu Zhiye, Wang Lili
Department of Cardiology, FuWai Hospital Chinese Academic of Medical Science, Shenzhen, Guangdong, China.
Arch Med Sci. 2019 Apr 11;16(3):545-550. doi: 10.5114/aoms.2019.84397. eCollection 2020.
The current study aimed to evaluate the association of anti-hyperuricemia treatment and prevalent cardiovascular disease (CVD) in hypertensive patients.
Primary hypertensive patients with hyperuricemia were enrolled. All participants were separated into two groups: anti-hyperuricemia and control groups (without anti-hyperuricemia treatment). Comparisons of prevalent CVD including coronary heart disease, ischemic stroke and heart failure were made and the associations of anti-hyperuricemia treatment and prevalent CVD were analyzed.
Compared to the anti-hyperuricemia group, patients in the control group had significantly higher serum C-reactive protein (10.6 ±2.8 vs. 7.4 ±1.2 mg/dl) and uric acid (UA) levels (438 ±33 vs. 379 ±64 µmol/l), and were more likely to receive β-blockers (34.2% vs. 31.1%) and calcium channel blockers (49.2% vs. 43.4%). The prevalence of ischemic stroke was higher in the control group (15.8% vs. 11.3%). Compared to other groups, blood pressure was significantly higher in patients in the 4 quartile serum UA level group. In the unadjusted model, anti-hyperuricemia treatment was significantly associated with a reduced odds ratio (OR) of composite CVD. After adjusting for potential covariates, OR of anti-hyperuricemia treatment for composite CVD was 0.89 with a 95% confidence interval (IC) of 0.82-0.98. Associations of anti-hyperuricemia treatment and ischemic stroke were also significant with OR = 0.93 and 95% CI: 0.88-0.99, while associations of anti-hyperuricemia with coronary heart disease and heart failure attenuated into insignificance after adjusting for covariates.
In hypertensive patients with hyperuricemia, anti-hyperuricemia treatment was associated with lower odds of prevalent CVD.
本研究旨在评估抗高尿酸血症治疗与高血压患者中普遍存在的心血管疾病(CVD)之间的关联。
纳入原发性高血压合并高尿酸血症患者。所有参与者被分为两组:抗高尿酸血症组和对照组(未进行抗高尿酸血症治疗)。对包括冠心病、缺血性卒中和心力衰竭在内的普遍存在的CVD进行比较,并分析抗高尿酸血症治疗与普遍存在的CVD之间的关联。
与抗高尿酸血症组相比,对照组患者的血清C反应蛋白(10.6±2.8 vs. 7.4±1.2mg/dl)和尿酸(UA)水平(438±33 vs. 379±64µmol/l)显著更高,并且更有可能接受β受体阻滞剂(34.2% vs. 31.1%)和钙通道阻滞剂(49.2% vs. 43.4%)。对照组中缺血性卒中的患病率更高(15.8% vs. 11.3%)。与其他组相比,血清UA水平处于第4四分位数组的患者血压显著更高。在未调整模型中,抗高尿酸血症治疗与复合CVD的比值比(OR)降低显著相关。在调整潜在协变量后,抗高尿酸血症治疗复合CVD的OR为0.89,95%置信区间(IC)为0.82 - 0.98。抗高尿酸血症治疗与缺血性卒中的关联也显著,OR = 0.93,95%CI:0.88 - 0.99,而在调整协变量后,抗高尿酸血症与冠心病和心力衰竭的关联减弱至无显著性。
在高血压合并高尿酸血症患者中,抗高尿酸血症治疗与普遍存在的CVD几率较低相关。