Serum uric acid predicts incident hypertension in a biethnic cohort - The atherosclerosis risk in communities study
Serum uric acid predicts incident hypertension in a biethnic cohort - The atherosclerosis risk in communities study
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DOI：
10.1161/01.hyp.0000249768.26560.66
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发表时间：
2006-12-01
期刊：
影响因子：
8.3
通讯作者：
Herrington, David M.
中科院分区：
文献类型：
--
作者：
Mellen, Philip B.;Bleyer, Anthony J.;Herrington, David M.
血尿酸与高血压发病率呈正相关，但以前的研究在探讨这种关系时，在性别和种族上的能力有限。我们试图在中年男性和女性的双种族队列中评估这种关联。在社区动脉粥样硬化风险（ARIC）研究中，基线时无高血压的参与者（N=9104）在4次检查中每隔3年评估一次高血压。校正后的考克斯比例风险模型评价了基线血清尿酸升高的每个SD的高血压事件或血液分类进展的风险。基线时，平均年龄为53.3岁（范围：45 - 64岁），平均（SD）收缩压为113.8（12.2）mm Hg，平均舒张压为70.2（8.6）mm Hg，平均血清尿酸为5.7（1.4）。在整个队列中，较高的血清尿酸与较高的高血压风险相关（尿酸升高的每个SD的风险比[95% CI]：1.10 [1.04 - 1.15]）和亚组分析（黑人男性：1.32 [1.14至1.54];黑人女性：1.16 [1.03至1.31];白色男性：1.01 [0.94至1.09];白色女性：1.04 [0.96 - 1.11]），校正年龄、基线血压、体重指数、肾功能、糖尿病和吸烟后。在建模血压进展时，模式相似（总体：1.10 [1.05 - 1.14];黑人男性：1.26 [ 1.11 - 1.42];黑人女性：1.18 [1.06 - 1.31];白色男性：1.05 [0.99 - 1.11];白色女性：1.05 [1.00 - 1.12]）。总之，在9年的随访中，血尿酸与高血压事件呈正相关，并且这种关系在黑人中比白人中更强。关于高尿酸血症的生理和临床后果，特别是在黑人中，需要进行更多的研究。
Serum uric acid has been positively associated with incident hypertension, but previous studies have had limited ability to explore this relationship across sex and ethnic strata. We sought to evaluate this association in a biethnic cohort of middle-aged men and women. Participants in the Atherosclerosis Risk in Communities (ARIC) study who were free of hypertension at baseline (N=9104) were evaluated for hypertension at 3-year intervals over 4 examinations. Adjusted Cox proportional hazards models evaluated risk of incident hypertension or progression of blood category for each SD higher baseline serum uric acid. At baseline, the mean age was 53.3 years ( range: 45 to 64 years), with a mean ( SD) systolic blood pressure of 113.8 (12.2) mm Hg, mean diastolic blood pressure of 70.2 (8.6) mm Hg, and mean serum uric acid of 5.7 (1.4). Higher serum uric acid was associated with greater risk of hypertension in the overall cohort ( hazard ratio for each SD of higher uric acid [95% CI]: 1.10 [1.04 to 1.15]) and in subgroup analyses ( black men: 1.32 [1.14 to 1.54]; black women: 1.16 [1.03 to 1.31]; white men: 1.01 [0.94 to 1.09]; white women: 1.04 [0.96 to 1.11]), after adjustment for age, baseline blood pressure, body mass index, renal function, diabetes, and smoking. The pattern was similar when modeling blood pressure progression ( overall: 1.10 [1.05 to 1.14]; black men: 1.26 [ 1.11 to 1.42]; black women: 1.18 [1.06 to 1.31]; white men: 1.05 [0.99 to 1.11]; white women: 1.05 [1.00 to 1.12]). In conclusion, serum uric acid was positively associated with incident hypertension over 9 years of follow-up, and this relationship was stronger in blacks than in whites. More research is warranted concerning the physiological and clinical consequences of hyperuricemia, especially in blacks.