Kawamoto Ryuichi, Ninomiya Daisuke, Akase Taichi, Asuka Kikuchi, Kumagi Teru
Department of Community Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Japan.
Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, Japan.
Clin Hypertens. 2020 Oct 15;26:20. doi: 10.1186/s40885-020-00155-x. eCollection 2020.
The risk associated with serum uric acid (SUA) levels when within the normal range is unknown. This study aims to examine whether SUA within the normal range is a predictor of hypertension.
The subjects comprised 704 men aged 71 ± 9 (mean ± standard deviation) years and 946 women aged 70 ± 8 years recruited for a survey at the community based annual medical check-up. The main outcome was the presence of hypertension (antihypertensive medication and/or having SBP ≥140 mmHg and/or DBP ≥90 mmHg).
At baseline, 467 (66.3%) men and 608 (64.3%) women had hypertension. Comparing to lowest quartile in women (SUA-1, uric acid < 4.1 mg/dL), the unadjusted odds ratios (ORs) [95% confidence interval (CI)] for hypertension of SUA-2 (4.1 to 4.7 mg/dL), SUA-3 (4.8 to 5.4 mg/dL), and SUA-4 (≥5.5 mg/dL) were 1.11 (0.78-1.59), 1.75 (1.20-2.55), and 1.89 (1.30-2.77), respectively. These associations were apparent even after adjustments for age, but ORs were attenuated after adjusting for all confounding factors. During a follow-up of 3.0 years, there were 35 (24.0%) hypertension cases in men and 51 (20.8%) in women. In women only, a significant association between increased SUA categories and incidence of hypertension was observed, and the multivariate-ORs (95% (CI) for incident hypertension of SUA-3 (4.5-5.2 mg/dL) and SUA-4 (≥5.3 mg/dL) were 2.23 (0.81-6.11) and 3.84 (1.36-10.8), respectively.
These results suggest that baseline SUA within the normal range could be an important predictor for incidence of hypertension in Japanese community-dwelling elderly women.
血清尿酸(SUA)水平在正常范围内时相关风险尚不清楚。本研究旨在探讨正常范围内的SUA是否为高血压的预测指标。
研究对象包括704名年龄为71±9(均值±标准差)岁的男性和946名年龄为70±8岁的女性,他们在社区年度体检中被招募进行调查。主要结局为高血压的存在情况(服用抗高血压药物和/或收缩压≥140mmHg和/或舒张压≥90mmHg)。
基线时,467名(66.3%)男性和608名(64.3%)女性患有高血压。与女性最低四分位数(SUA-1,尿酸<4.1mg/dL)相比,SUA-2(4.1至4.7mg/dL)、SUA-3(4.8至5.4mg/dL)和SUA-4(≥5.5mg/dL)高血压的未调整比值比(OR)[95%置信区间(CI)]分别为1.11(0.78-1.59)、1.75(1.20-2.55)和1.89(1.30-2.77)。即使在调整年龄后这些关联仍很明显,但在调整所有混杂因素后OR值减弱。在为期3.0年的随访中,男性有35例(24.0%)高血压病例,女性有51例(20.8%)。仅在女性中,观察到SUA类别增加与高血压发病率之间存在显著关联,SUA-3(4.5-5.2mg/dL)和SUA-4(≥5.3mg/dL)新发高血压的多变量OR(95%CI)分别为2.23(0.81-6.11)和3.84(1.36-10.8)。
这些结果表明,正常范围内的基线SUA可能是日本社区居住老年女性高血压发病率的重要预测指标。