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血清尿酸升高与心血管疾病:综述及潜在治疗干预措施

Elevated Serum Uric Acid and Cardiovascular Disease: A Review and Potential Therapeutic Interventions.

作者信息

Freilich Michael, Arredondo Andrew, Zonnoor Seyedeh Leila, McFarlane Isabel M

机构信息

Internal Medicine, State University of New York Downstate Health Sciences University, Brooklyn, USA.

出版信息

Cureus. 2022 Mar 28;14(3):e23582. doi: 10.7759/cureus.23582. eCollection 2022 Mar.

Abstract

Several landmark studies found a relationship between elevated serum uric acid (SUA) levels and cardiovascular disease (CVD). In fact, the association between hyperuricemia and hypertension (HTN), coronary artery disease (CAD), and heart failure (HF) is currently well-established. While the mechanism linking hyperuricemia and CVD is not fully known, a systemic inflammatory response by the host is believed to play a role. With the goal of decreasing the morbidity and mortality of CVD in patients with hyperuricemia, the focus has now turned to properly optimizing a medication regimen for this patient population. Recent studies have shown that controlling underlying inflammation can, in fact, lead to better cardiovascular outcomes for populations with acute and chronic coronary disease. In this paper, we will discuss the current state of understanding on the association of hyperuricemia and cardiovascular disease. Furthermore, we will look into the most recent clinical trials showing the effects anti-inflammatory medications have on both decreasing and recovering from cardiovascular events. We will conclude with a discussion on, given the information mentioned above, how to properly optimize a medication regimen in patients with elevated SUA levels with a focus on decreasing the morbidity and mortality associated with CVD.

摘要

多项具有里程碑意义的研究发现血清尿酸(SUA)水平升高与心血管疾病(CVD)之间存在关联。事实上,高尿酸血症与高血压(HTN)、冠状动脉疾病(CAD)和心力衰竭(HF)之间的关联目前已得到充分证实。虽然高尿酸血症与心血管疾病之间的联系机制尚未完全明确,但据信宿主的全身炎症反应起到了一定作用。为了降低高尿酸血症患者心血管疾病的发病率和死亡率,目前的重点已转向为该患者群体合理优化药物治疗方案。最近的研究表明,控制潜在炎症实际上可以为患有急性和慢性冠状动脉疾病的人群带来更好的心血管结局。在本文中,我们将讨论关于高尿酸血症与心血管疾病关联的当前认识状况。此外,我们将探讨显示抗炎药物对减少心血管事件及从心血管事件中恢复的效果的最新临床试验。我们将以上述信息为基础,讨论如何合理优化SUA水平升高患者的药物治疗方案,重点是降低与心血管疾病相关的发病率和死亡率。

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