Department of Ultrasound, the First Affiliated Hospital of Shantou University Medical College, Shantou, China.
Department of Interventional Ultrasound, the Second Affiliated Hospital of Shantou University Medical College, Shantou, China.
Front Endocrinol (Lausanne). 2024 Jan 31;15:1343998. doi: 10.3389/fendo.2024.1343998. eCollection 2024.
Serum uric acid (SUA) has been suggested as a contributor of hypertension. However, reports on the relationship between changes in SUA and hypertension are limited. Hence, we aimed to investigate the potential impact of SUA, especially its change over time, on hypertension incidence.
This dynamic cohort included 6052 participants without hypertension at baseline. Participants were categorized into six grades based on whether baseline SUA was high and whether changes in SUA progressed to hyperuricemia or decreased to normal levels. Grades 1 to 6 represented the participants' SUA control from best to worst. Logistic regression and restricted cubic spline (RCS) models were used to explore the association of the grades of SUA control and hypertension incidence.
During a median follow-up of 6 years, 2550 (42.1%) participants developed hypertension. After adjusting confounding factors, compared to grade 1 with the best control of SUA, the odds ratios for grades 2 to 6 with worse control were 1.347 (1.109-1.636), 1.138 (0.764-1.693), 1.552 (1.245-1.934), 1.765 (1.170-2.663), and 2.165 (1.566-2.993), respectively. RCS indicated a linear correlation between the risk of hypertension and changes in SUA, and an elevated risk in participants with baseline hyperuricemia. Subgroup analyses showed that grades of SUA control had an interaction with systolic ( = 0.003) and diastolic blood pressure ( < 0.001). Sensitivity analyses further determined the robustness of the result that participants with poor SUA control have a higher risk of developing hypertension.
Poor SUA control, an increase in SUA over time, rises the risk of developing hypertension regardless of whether the initial SUA is normal or not. Initial hyperuricemia will exacerbate this risk. Effective SUA control should be an important measure for primary prevention of hypertension.
血清尿酸（SUA）已被认为是高血压的一个致病因素。然而，关于 SUA 变化与高血压之间关系的报告有限。因此，我们旨在研究 SUA，特别是其随时间变化的情况，对高血压发病率的潜在影响。
本动态队列研究纳入了 6052 名基线时无高血压的参与者。根据基线 SUA 是否偏高以及 SUA 是否逐渐升高至高尿酸血症或降低至正常水平，将参与者分为六组。第 1 组至第 6 组代表参与者 SUA 控制从最佳到最差的情况。使用逻辑回归和限制性三次样条（RCS）模型来探讨 SUA 控制等级与高血压发病率之间的关联。
在中位随访 6 年期间，2550（42.1%）名参与者发生了高血压。调整混杂因素后，与 SUA 控制最佳的第 1 组相比，SUA 控制较差的第 2 组至第 6 组的比值比分别为 1.347（1.109-1.636）、1.138（0.764-1.693）、1.552（1.245-1.934）、1.765（1.170-2.663）和 2.165（1.566-2.993）。RCS 表明，高血压的风险与 SUA 的变化之间呈线性相关，基线时高尿酸血症的参与者风险升高。亚组分析显示，SUA 控制等级与收缩压（ = 0.003）和舒张压（ < 0.001）存在交互作用。敏感性分析进一步证实了控制不佳的 SUA 与高血压发病风险升高之间的关系具有稳健性。
无论初始 SUA 是否正常，SUA 控制不佳、SUA 随时间升高都会增加高血压发病风险，而初始高尿酸血症会加重这种风险。有效的 SUA 控制应作为高血压一级预防的重要措施。
