Reporter: Aviva Lev-Ari, PhD, RN
- Original Article
HYPERTENSIONAHA.113.00859 Published online before print May 20, 2013,doi: 10.1161/HYPERTENSIONAHA.113.00859
- Jesse Dawson,
- Panniyammakal Jeemon,
- Lucy Hetherington,
- Caitlin Judd,
- Claire Hastie,
- Christin Schulz,
- William Sloan,
- Scott Muir,
- Alan Jardine,
- Gordon McInnes,
- David Morrison,
- Anna Dominiczak,
- Sandosh Padmanabhan,
- Matthew Walters
+Author Affiliations
From the Institute of Cardiovascular and Medical Sciences (J.D., P.J., L.H., C.J., C.H., C.S., S.M., A.J., G.M., A.D., S.P., M.W.), West of Scotland Cancer Surveillance Unit (W.S., D.M.), College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom.
- Correspondence to Matthew Walters, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary & Life Sciences, Western Infirmary, University of Glasgow, Glasgow G11 6NT, United Kingdom. E-mail matthew.walters@glasgow.ac.uk; or Sandosh Padmanabhan, BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, 126 University Pl, University of Glasgow, Glasgow G12 8TA, United Kingdom. E-mail Sandosh.padmanabhan@glasgow.ac.uk
Abstract
Uric acid may have a role in the development of hypertension and renal dysfunction. We explored the relationship among longitudinal blood pressure, renal function, and cardiovascular outcomes in a large cohort of patients with treated hypertension. We used data from the Glasgow Blood Pressure Clinic database. Patients with a baseline measure of serum uric acid and longitudinal measures of blood pressure and renal function were included. Mortality data were obtained from the General Register Office for Scotland. Generalized estimating equations were used to explore the relationship among quartiles of serum uric acid, blood pressure, and estimated glomerular filtration rate. Cox proportional hazard models were developed to assess mortality relationships. In total, 6984 patients were included. Serum uric acid level did not influence the longitudinal changes in systolic or diastolic blood pressure but was related to change in glomerular filtration rate. In comparison with patients in the first quartile of serum uric acid, the relative decrease in glomerular filtration rate in the fourth was 10.7 (95% confidence interval, 7.9–13.6 mL/min per 1.73 m2) in men and 12.2 (95% confidence interval, 9.2–15.2 mL/min per 1.73 m2) in women. All-cause and cardiovascular mortality differed across quartiles of serum uric acid in women only (P<0.001; hazard ratios for all-cause mortality 1.38 [95% confidence interval, 1.14–1.67] for the fourth quartile of serum uric acid compared with the first). Serum uric acid level was not associated with longitudinal blood pressure control in adults with treated hypertension but was related to decline in renal function and mortality in women.
Key Words:
- Received February 19, 2013.
- Revision received April 23, 2013.
- Accepted April 23, 2013.
- © 2013 American Heart Association, Inc.
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