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The impact of serum uric acid on cardiovascular outcomes in the LIFE study

Aud Høieggen1, Michael H Alderman, Sverre E Kjeldsen

  • 1Departments of Nephrology and Cardiology, Ullevaal University Hospital, Oslo, Norway. aud.hoieggen@ioks.uio.no

Kidney International
|February 12, 2004
PubMed

Insights

Losartan treatment attenuated serum uric acid (SUA) increases compared to atenolol, explaining 29% of the cardiovascular benefit. This reduction in SUA was more pronounced in women, highlighting its role in hypertension management.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Metabolic Syndrome

Background:

  • The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study showed losartan's superiority over atenolol in reducing cardiovascular (CV) morbidity and mortality.
  • Serum uric acid (SUA) is a potential independent risk factor for CV events, and its modulation by losartan may explain the LIFE study's findings.

Purpose of the Study:

  • To investigate the relationship between serum uric acid (SUA) levels and cardiovascular (CV) outcomes in the LIFE study.
  • To determine if SUA levels mediate the CV benefits observed with losartan compared to atenolol.

Main Methods:

  • Cox regression analysis was employed to assess the association between SUA, treatment regimens, and the primary composite CV outcome.
  • Baseline and time-varying SUA levels were analyzed, with adjustments for the Framingham risk score (FRS).

Main Results:

  • Baseline SUA was significantly associated with increased CV events, particularly in women.
  • The increase in SUA over the study period was significantly attenuated by losartan compared to atenolol.
  • Time-varying SUA was strongly associated with CV events, and this association was more pronounced in women.

Conclusions:

  • Losartan treatment attenuated the increase in SUA compared to atenolol, accounting for 29% of the observed treatment effect on the primary composite endpoint.
  • The association between SUA and CV events was stronger in women than in men, irrespective of FRS adjustment.
Abstract

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