Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.
National Institute of Occupational Safety and Health Japan, Japan Organization of Occupational Health and Safety, Kawasaki City, Japan.
J Clin Hypertens (Greenwich). 2023 Mar;25(3):295-303. doi: 10.1111/jch.14644. Epub 2023 Feb 15.
The authors examined the sex-specific association between serum uric acid (SUA) levels and achievement of target blood pressure among Japanese patients with hypertension. This cross-sectional study was conducted between January 2012 and December 2015 and examined 17 113 eligible participants (6499 men; 10 614 women) with hypertension among 66 874 Japanese community residents who underwent voluntary health checkups. Multivariate analysis was used to estimate the association between high SUA level (≥7.0 mg/dL for men and ≥6.0 mg/dL for women) and "therapeutic failure" in achieving target blood pressure (BP) of 140/90 and 130/80 mmHg in both sexes. Multivariate analysis revealed that high SUA level was significantly associated with failure to achieve the 130/80 mmHg treatment goal among men (AOR = 1.24, 95% CI = 1.03-1.50, p = .03). Among women, high SUA level was significantly associated with failure to achieve both the 130/80 and 140/90 mmHg treatment goals (AOR = 1.33, 95% CI = 1.20-1.47, p < .01 and AOR = 1.17, 95% CI = 1.04-1.32, p < .01, respectively). Each increase in SUA quartile was positively associated with increases in systolic BP (SBP) and diastolic BP (DBP) (p < .01 for trend) in both sexes. SBP and DBP in each quartile (Q2-Q4) were also significantly higher compared with those of Q1 in both sexes (p < .01). Our data confirms the difficulties in maintain goal BP control in those with elevated SUA.
作者研究了血清尿酸(SUA)水平与日本高血压患者血压达标之间的性别特异性关联。这项横断面研究于 2012 年 1 月至 2015 年 12 月进行,共纳入了 66874 名日本社区居民中 17113 名符合条件的高血压患者(男性 6499 名,女性 10614 名),这些人参加了自愿健康检查。多变量分析用于估计高 SUA 水平(男性≥7.0mg/dL,女性≥6.0mg/dL)与两性患者未能达到 140/90mmHg 和 130/80mmHg 的目标血压之间的关系。多变量分析显示,高 SUA 水平与男性未能达到 130/80mmHg 的治疗目标显著相关(OR=1.24,95%CI=1.03-1.50,p=0.03)。在女性中,高 SUA 水平与未能达到 130/80mmHg 和 140/90mmHg 的治疗目标均显著相关(OR=1.33,95%CI=1.20-1.47,p<.01;OR=1.17,95%CI=1.04-1.32,p<.01)。SUA 四分位区间每增加一个单位,与两性的收缩压(SBP)和舒张压(DBP)均呈正相关(趋势 p<.01)。两性中,每个四分位区间(Q2-Q4)的 SBP 和 DBP 也明显高于 Q1(p<.01)。我们的数据证实了尿酸升高的患者在维持目标血压控制方面存在困难。