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Higher baseline uric acid concentration is associated with non-attainment of optimal blood pressure

Yuji Sato1, Shouichi Fujimoto2,3, Kunitoshi Iseki3

  • 1Division of Nephrology, Department of Internal Medicine, National Health Insurance Takachiho Town Hospital, Takachiho, Miyazaki, Japan.

Plos One
|July 28, 2020
PubMed

Insights

Higher baseline uric acid levels are linked to poorer blood pressure control in individuals starting antihypertensive drugs. This suggests elevated uric acid may predict treatment challenges for hypertension management.

Area of Science:

  • Cardiology
  • Nephrology
  • Metabolic Disorders

Background:

  • Elevated uric acid is linked to hypertension prevalence and incidence.
  • Limited data exists on uric acid's impact on antihypertensive drug efficacy.
  • Understanding this relationship is crucial for effective hypertension management.

Purpose of the Study:

  • To investigate the association between baseline uric acid concentration and the non-attainment of optimal blood pressure (NOBP) in individuals initiating antihypertensive therapy.
  • To assess if higher uric acid levels predict suboptimal blood pressure control under medication.

Main Methods:

  • Prospective cohort study of 8,664 Japanese adults (mean age 65.5 years).
  • Participants initiated antihypertensive drugs after baseline health check-up.
  • Blood pressure control (NOBP) was assessed, and participants were stratified by baseline uric acid quartiles.

Main Results:

  • The highest quartile of baseline uric acid was significantly associated with NOBP (OR 1.36; 95% CI 1.16-1.59).
  • This association remained significant after adjusting for confounders like age, sex, BMI, diabetes, dyslipidemia, CKD, cardiovascular disease history, alcohol, and smoking.
  • Subgroup analyses in women, and those with diabetes and CKD, showed a significant link between +1 mg/dL of uric acid and NOBP.

Conclusions:

  • Higher baseline uric acid concentration is a significant predictor of suboptimal blood pressure control upon initiation of antihypertensive drug therapy.
  • Elevated uric acid may indicate a poorer response to standard antihypertensive treatments.
  • Further research is warranted to explore mechanisms and therapeutic strategies targeting uric acid in hypertension management.

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