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高尿酸血症及降尿酸药物对心血管疾病的影响

Impact of Hyperuricemia and Urate-Lowering Agents on Cardiovascular Diseases.

作者信息

Sosa Franklin, Shaban Mohammed, Lopez Jose, Duarte Gustavo J, Jain Swati, Khizar Asma, Vittorio Timothy, Mishra Rishabh, Rodriguez Guerra Miguel

机构信息

BronxCare Health System, Icahn School of Medicine, Bronx, NY, USA.

Division of Cardiovascular Disease, University of Miami Miller School of Medicine/JFK Hospital, Atlantis, FL, USA.

出版信息

Clin Med Insights Cardiol. 2024 Mar 24;18:11795468241239542. doi: 10.1177/11795468241239542. eCollection 2024.

Abstract

The association between hyperuricemia and cardiovascular diseases has been studied for many years. Research has shown a link between high uric acid levels and increased risk of including coronary artery disease hypertension and other cardiovascular conditions. Urate-lowering therapy, particularly with xanthine oxidase inhibitors like allopurinol, has shown promising results in reducing blood pressure in individuals with hyperuricemia and hypertension. Clinical trials and studies have demonstrated significant reductions in both systolic and diastolic blood pressure with urate-lowering treatment. Urate-lowering treatment has shown a favorable effect on reducing systolic blood pressure and major adverse cardiovascular events in patients with previous cardiovascular disease. In terms of cardiovascular safety, clinical trials have indicated that xanthine oxidase inhibitors such as febuxostat are non-inferior to allopurinol and do not increase the risk of death or serious adverse events. Overall, these findings highlight the importance of managing hyperuricemia and utilizing urate-lowering therapy to mitigate the adverse cardiovascular effects associated with elevated uric acid levels.

摘要

高尿酸血症与心血管疾病之间的关联已被研究多年。研究表明,高尿酸水平与包括冠状动脉疾病、高血压和其他心血管疾病在内的患病风险增加之间存在联系。降尿酸治疗,尤其是使用别嘌醇等黄嘌呤氧化酶抑制剂,已在降低高尿酸血症和高血压患者的血压方面显示出有前景的结果。临床试验和研究表明,降尿酸治疗可显著降低收缩压和舒张压。降尿酸治疗已显示出对降低既往有心血管疾病患者的收缩压和主要不良心血管事件有良好效果。在心血管安全性方面,临床试验表明,非布司他等黄嘌呤氧化酶抑制剂不劣于别嘌醇,且不会增加死亡或严重不良事件的风险。总体而言,这些发现凸显了控制高尿酸血症以及利用降尿酸治疗来减轻与尿酸水平升高相关的心血管不良影响的重要性。

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