Prognostic value of serumuric acid: new-onset in and out-of-office hypertension and long-termmortality
Prognostic value of serumuric acid: new-onset in and out-of-office hypertension and long-termmortality
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DOI：
10.1097/hjh.0000000000000161
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发表时间：
2014-06-01
影响因子：
4.9
通讯作者：
Mancia, Giuseppe
中科院分区：
文献类型：
--
作者：
Bombelli, Michele;Ronchi, Irene;Mancia, Giuseppe
目的：血清尿酸（SUA）与心血管风险增加有关，但没有确凿的证据表明它是一个独立的危险因素还是与其相关的其他危险因素的反映。我们检查了 SUA 与许多心血管变量的关系（包括以前从未评估过的危险因素，如器官损伤和诊室外血压 (BP)），以及其在人群中的预后相关性。方法：在 Pressioni Arteriose Monitorate E Loro Associazioni 研究的 2045 名参与者中，我们除了 SUA 之外还测量了代谢、肾脏和人体测量指标 变量、左心室质量指数以及办公室、家庭和动态血压。在 16 年的随访期内评估心血管和全因死亡率，并在初始数据收集后 10 年重复测量。结果：基线 SUA 呈接近正态分布，平均值为 4.91.3 (SD) mg/dl，与血压和代谢变量、血清肌酐和左心室质量指数有显着的直接关系。它是独立预测新发家庭高血压和动态高血压的因素之一，在调整所有可用的潜在混杂因素后，SUA 增加 1mg/dl 时，发生这些疾病的风险增加分别为 34% 和 29%（P=0.015 和 P=0.014）。 SUA 增加 1mg/dl 也可以独立预测心血管死亡率和全因死亡率，完全调整后的风险增加分别为 22% (P=0.03) 和 12% (P=0.04)。 结论：在 Pressioni Arteriose Monitorate E Loro Associazioni 研究的一般人群中，SUA 与许多心血管危险因素相关。然而，它可以独立预测新发的诊室外高血压以及长期心血管和全因死亡率。
Objective:Serum uric acid (SUA) has been associated with an increased cardiovascular risk, but no conclusive evidence exists on whether it is an independent risk factor or a reflection of other risk factors to which it is related. We examined the relationship of SUA with a number of cardiovascular variables [including risk factors never evaluated before, such as organ damage and out-of-office blood pressure (BP)], as well as its prognostic relevance in the population.Methods:In 2045 participants of the Pressioni Arteriose Monitorate E Loro Associazioni study, we measured, along with SUA, metabolic, renal, and anthropometric variables, left-ventricular mass index, and office, home and ambulatory BP. Cardiovascular and all-cause mortality was assessed over a 16-year follow-up period, and measurements were repeated 10 years after the initial data collection.Results:Baseline SUA had a near-normal distribution, with a mean value of 4.91.3 (SD) mg/dl and a significant direct relationship with BP and metabolic variables, serum creatinine and left-ventricular mass index. It was among the factors independently predicting new-onset home and ambulatory hypertension, the increased risk of developing these conditions for 1mg/dl increase of SUA after adjustment for all available potential confounders being 34 and 29%, respectively (P=0.015 and P=0.014). An increase in SUA of 1mg/dl also independently predicted cardiovascular and all-cause mortality, the fully adjusted increase in risk being 22% (P=0.03) and 12% (P=0.04), respectively.Conclusion:In the general population of the Pressioni Arteriose Monitorate E Loro Associazioni study, SUA correlated with a number of cardiovascular risk factors. Nevertheless, it independently predicts new-onset out-of-office hypertension, and long-term cardiovascular and all-cause mortality.