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Hypertension, its treatment, hyperuricaemia and gout

Terence J Gibson1

  • 1Department of Rheumatology, Guys and St Thomas Hospitals, London, UK. Terence.Gibson@kcl.ac.uk

Current Opinion in Rheumatology
|February 2, 2013
PubMed

Insights

Hyperuricemia, a condition of high uric acid, is increasingly linked to hypertension. Emerging evidence suggests hyperuricemia may cause hypertension, challenging traditional views and highlighting the need for new treatments.

Area of Science:

  • Nephrology
  • Rheumatology
  • Cardiology

Background:

  • Gout and hyperuricemia are increasingly prevalent globally.
  • Established association between hyperuricemia, gout, hypertension, and chronic kidney disease.
  • Causal relationship between these conditions remains controversial.

Purpose of the Study:

  • To review studies addressing the complex relationship between hyperuricemia and hypertension.
  • To evaluate evidence for hyperuricemia as a cause of hypertension.
  • To explore the impact of diuretics on hyperuricemia and hypertension.

Main Methods:

  • Systematic review of epidemiological surveys and relevant studies.
  • Analysis of data on hyperuricemia, hypertension, and associated confounders.
  • Examination of proposed mechanisms for diuretic-induced hyperuricemia.

Main Results:

  • Strong epidemiological evidence links gout and hyperuricemia with hypertension and diuretic use.
  • Hyperuricemia is suggested to directly cause hypertension and renovascular disease.
  • Diuretic-induced hyperuricemia may result from volume depletion and reduced uric acid secretion, potentially influenced by genetics.

Conclusions:

  • Recent data challenge the notion that renal dysfunction or shared factors solely explain the hyperuricemia-hypertension link.
  • Evidence suggests hyperuricemia actively contributes to hypertension development.
  • Development of uricosuric diuretics is needed, and losartan shows promise for hypertensive patients with gout.
Abstract

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