Dose-response association of uncontrolled blood pressure and cardiovascular disease risk factors with hyperuricemia and gout.
Dose-response association of uncontrolled blood pressure and cardiovascular disease risk factors with hyperuricemia and gout.
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DOI：
10.1371/journal.pone.0056546
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Gelber AC
中科院分区：
文献类型：
--
作者：
Juraschek SP;Kovell LC;Miller ER;Gelber AC
高血压的一线治疗包括利尿剂，已知利尿剂会成倍增加痛风的风险。详细了解高尿酸血症和痛风的潜在患病率与血压（BP）和常见的合并症的人是有用的从业人员开始抗高血压药物。我们量化了血压不受控制和其他心血管疾病（CVD）危险因素的人群中高尿酸血症和痛风的患病率。我们使用1988-1994年和1999-2010年的国家健康与营养调查，对18岁及以上的非住院美国成年人进行了横断面研究。高尿酸血症定义为女性血清尿酸>6.0 mg/dL；男性7.0 mg/dL。通过医生诊断痛风的自我报告来确定痛风。未控制血压以收缩压≥140 mmHg和舒张压≥90 mmHg为基础。其他心血管疾病的危险因素包括肥胖、肾小球滤过率降低和血脂异常。在健康的美国成年人中，高尿酸血症的患病率为6-8%，在血压未控制的成年人中为10-15%，血压未控制的成年人中为22-25%并有一个额外的心血管疾病危险因素，而血压未控制的成年人中为34-37%并有两个额外的心血管疾病危险因素。同样，在相同的健康状况类别中，痛风的患病率依次较高，分别为1-2%、4-5%、6-8%和8-12%。2007-2010年，与没有心血管疾病危险因素的患者相比，血压不受控制和另外2个心血管疾病危险因素的患者在高尿酸血症和痛风方面的患病率分别为4.5 （95% CI 3.5-5.6）和4.5 (95% CI 3.1-6.3) （P<0.01）。卫生保健提供者应该认识到，在血压不受控制和其他心血管疾病危险因素的患者中，高尿酸血症和痛风的患病率逐渐升高。在有多种心血管疾病危险因素的人群中，有三分之一的人患有高尿酸血症，医生应该仔细考虑他们的抗高血压方案，并潜在地筛查高尿酸血症或痛风。
First-line therapy of hypertension includes diuretics, known to exert a multiplicative increase on the risk of gout. Detailed insight into the underlying prevalence of hyperuricemia and gout in persons with uncontrolled blood pressure (BP) and common comorbidities is informative to practitioners initiating antihypertensive agents. We quantify the prevalence of hyperuricemia and gout in persons with uncontrolled BP and additional cardiovascular disease (CVD) risk factors. We performed a cross-sectional study of non-institutionalized US adults, 18 years and older, using the National Health and Nutrition Examination Surveys in 1988–1994 and 1999–2010. Hyperuricemia was defined as serum uric acid >6.0 mg/dL in women; >7.0 mg/dL in men. Gout was ascertained by self-report of physician-diagnosed gout. Uncontrolled BP was based on measured systolic BP≥140 mmHg and diastolic BP≥90 mmHg. Additional CVD risk factors included obesity, reduced glomerular filtration rate, and dyslipidemia. The prevalence of hyperuricemia was 6–8% among healthy US adults, 10–15% among adults with uncontrolled BP, 22–25% with uncontrolled BP and one additional CVD risk factor, and 34–37% with uncontrolled BP and two additional CVD risk factors. Similarly, the prevalence of gout was successively greater, at 1–2%, 4–5%, 6–8%, and 8–12%, respectively, across these same health status categories. In 2007–2010, those with uncontrolled BP and 2 additional CVD risk factors compared to those without CVD risk factors had prevalence ratios of 4.5 (95% CI 3.5–5.6) and 4.5 (95% CI: 3.1–6.3) for hyperuricemia and gout respectively (P<0.01). Health care providers should be cognizant of the incrementally higher prevalence of hyperuricemia and gout among patients with uncontrolled BP and additional CVD risk factors. With one in three people affected by hyperuricemia among those with several CVD risk factors, physicians should consider their anti-hypertensive regimens carefully and potentially screen for hyperuricemia or gout.
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影响因子：
120.7
作者：
de Boer, Ian H.;Rue, Tessa C.;Hall, Yoshio N.;Heagerty, Patrick J.;Weiss, Noel S.;Himmelfarb, Jonathan
通讯作者：
Himmelfarb, Jonathan
影响因子：
16.2
作者：
American Diabetes Association
通讯作者：
American Diabetes Association
DOI：
10.1002/art.22466
发表时间：
2007-02-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Choi, Hyon K.;Ford, Earl S.;Curhan, Gary
通讯作者：
Curhan, Gary
影响因子：
37.8
作者：
Alberti, K. G. M. M.;Eckel, Robert H.;Smith, Sidney C., Jr.
通讯作者：
Smith, Sidney C., Jr.
影响因子：
120.7
作者：
Egan, Brent M.;Zhao, Yumin;Axon, R. Neal
通讯作者：
Axon, R. Neal