University of Alabama at Birmingham, Birmingham, Alabama.
Hospital for Special Surgery and Weill Cornell Medical College, New York, New York, USA.
J Hypertens. 2023 Jun 1;41(6):1033-1039. doi: 10.1097/HJH.0000000000003425. Epub 2023 Apr 4.
Prior studies have identified an association between hypertension and hyperuricemia; however, there has been limited research on the association between hypertension severity and hyperuricemia.
We studied 997 Black and white adults with serum urate data from the reasons for geographic and racial differences in stroke (REGARDS) study. Hypertension was defined as SBP ≥ 140 mmHg or DBP ≥ 90 mmHg or self-reported use of antihypertensive medication. Apparent treatment-resistant hypertension (aTRH) was defined as a SBP ≥ 140 mmHg or DBP ≥ 90 mmHg with concurrent use of three classes of antihypertensive medications, or taking four or more classes of antihypertensive medication regardless of BP level. Controlled BP was defined as SBP <140 mmHg and DBP <90 mmHg.
Overall 5.9% of participants had aTRH and 36.6% had hyperuricemia, defined as serum urate >7.0 mg/dl for men and >6.0 mg/dl for women. After full multivariable adjustment, the odds ratio (OR) for hyperuricemia associated with hypertension was 1.60 [95% confidence interval (95% CI): 1.06-2.40]. Compared to participants not taking antihypertensive medication, the ORs for hyperuricemia for participants taking one, two and three classes of antihypertensive medication without aTRH were 1.98 (95% CI: 1.23-3.20), 2.08 (95% CI: 1.25-3.43), 4.31 (95% CI: 2.07-8.97), respectively, and 3.96 (95% CI: 1.75-8.96) for aTRH. Compared to participants without hypertension, the odds ratios for hyperuricemia were 1.67 (95% CI: 1.08-2.58) and 1.46 (95% CI: 0.88-2.44) among those with hypertension with and without controlled BP, respectively. Diuretic use was associated with a higher odds of hyperuricemia.
This study suggests that individuals taking more classes of antihypertensive medication may benefit from monitoring for hyperuricemia.
先前的研究已经确定了高血压与高尿酸血症之间的关联；然而，关于高血压严重程度与高尿酸血症之间的关联的研究有限。
我们研究了来自地理和种族差异中风原因（REGARDS）研究的 997 名黑人和白人成年人的血清尿酸数据。高血压定义为 SBP≥140mmHg 或 DBP≥90mmHg 或报告使用抗高血压药物。明显治疗抵抗性高血压（aTRH）定义为 SBP≥140mmHg 或 DBP≥90mmHg 同时使用三类抗高血压药物，或无论血压水平如何，服用四类或更多类抗高血压药物。控制血压定义为 SBP<140mmHg 和 DBP<90mmHg。
总体而言，5.9%的参与者患有 aTRH，36.6%患有高尿酸血症，定义为男性血清尿酸>7.0mg/dl，女性>6.0mg/dl。经过充分的多变量调整后，与高血压相关的高尿酸血症的比值比（OR）为 1.60[95%置信区间（95%CI）：1.06-2.40]。与未服用抗高血压药物的参与者相比，不伴有 aTRH 时服用一种、两种和三种抗高血压药物的参与者发生高尿酸血症的 OR 分别为 1.98（95%CI：1.23-3.20）、2.08（95%CI：1.25-3.43）、4.31（95%CI：2.07-8.97）和 3.96（95%CI：1.75-8.96），而 aTRH 的 OR 为 3.96（95%CI：1.75-8.96）。与无高血压的参与者相比，伴有和不伴有控制血压的高血压参与者的高尿酸血症的比值比分别为 1.67（95%CI：1.08-2.58）和 1.46（95%CI：0.88-2.44）。利尿剂的使用与高尿酸血症的发生几率增加有关。
本研究表明，服用更多种类的抗高血压药物的个体可能需要监测高尿酸血症。
