Asymptomatic hyperuricemia is a strong risk factor for resistant hypertension in elderly subjects from general population

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• 作者：Alberto Mazza^a ; Salvatore Lenti^b ; Laura Schiavon^c ; Alvise Del Monte^c ; Danyelle M. Townsend^d ; Emilio Ramazzina^c ; Domenico Rubello^e ; ^{Domenico.rubello@libero.it} ; Edoardo Casiglia^f
• 关键词：Cardiovascular risk ; Epidemiology ; Resistant hypertension ; Uric acid
• 刊名：Biomedicine & Pharmacotherapy
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：86
• 期：Complete
• 页码：590-594
• 全文大小：448 K
• 卷排序：86

文摘

In clinical practice, patient characteristics predicting resistant hypertension (RH) include higher blood pressure levels, left ventricular hypertrophy, older age, obesity, chronic kidney disease and diabetes. On the contrary little is known about the role of serum uric acid (SUA) as a risk factor for RH in subjects from general population.Material and methods580 elderly subjects aged ≥65 years were enrolled in the Risk Of Vascular complications Impact of Genetics in Old people (ROVIGO) study. RH was defined as the failure to maintain blood pressure values below 140 mmHg (systolic) and 90 mmHg (diastolic) despite therapeutic interventions that include appropriate lifestyle measures plus adherence to treatment with full doses of at least three antihypertensive drugs, including a diuretic. RH was confirmed using 24-h ambulatory blood pressure measurement. Hyperuricemic was defined as the subjects having SUA ≥6.8 mg/dl or taking uricosuric drugs. Gender-specific odds ratio (OR) for RH was calculated by logistic regression analysis.ResultsThe prevalence of RH was 5.7% in the cohort and was higher in women (8.3%) than in men (3.0%, p < 0.05). Independent of chronic kidney disease (OR 3.89, 95% confidence interval 1.49–10.1), hyperuricemia predicted resistant hypertension in women (odds ratio 3.11, 95% confidence intervals 1.06–9.1, p = 0.03) but not in men.ConclusionsIn elderly women from the general population, an SUA value of ≥6.8 mg/dl triples the risk of RH. SUA assessment should be recommended to better define the pattern of risk associated with RH.