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U-Shaped Association Between Serum Uric Acid Level and Hypertensive Heart Failure: A Genetic Matching Case-Control

Hongxuan Xu1,2, Quan Wang3, Yunqing Liu1,2

  • 1Chinese Academy of Medical Sciences, National Center of Gerontology, National Health Commission, Department of Cardiology, Beijing Hospital, Institute of Geriatric Medicine, Beijing, China.

Frontiers in Cardiovascular Medicine
|December 27, 2021
PubMed

Insights

Both low and high serum uric acid levels predict hypertensive heart failure (HHF). This U-shaped relationship highlights uric acid

Area of Science:

  • Cardiology
  • Nephrology
  • Metabolic Syndrome

Background:

  • Heart failure (HF) represents a significant global health challenge with substantial public healthcare costs.
  • Existing research suggests a link between abnormal serum uric acid levels (both high and low) and adverse outcomes in various conditions.
  • The potential benefit of reduced serum uric acid levels in heart failure outcomes requires further investigation.

Purpose of the Study:

  • To investigate the association between serum uric acid levels and hypertensive heart failure (HHF).
  • To explore the relationship between uric acid levels and HHF using a matched cross-sectional study design.
  • To identify other associated metabolic factors, such as fasting blood sugar and lipid profiles, in HHF.

Main Methods:

  • A comparative, matched cross-sectional study design was employed.
  • Patients diagnosed with hypertension or HHF admitted to Beijing Hospital's cardiology department were identified via electronic medical records.
  • Matching criteria included age, sex, body mass index (BMI), blood pressure (BP), and medical histories of chronic kidney disease (CKD), cardiovascular disease (CVD), diabetes mellitus, stroke, and hyperlipidemia.

Main Results:

  • Univariate logistic regression revealed a significant U-shaped relationship between serum uric acid (UA) levels and HHF (quadratic term significant, P=0.03).
  • The median age of the matched groups was 71 years, with males comprising 55.6% of the hypertension group and 53.8% of the HHF group.
  • Fasting blood sugar (FBS) and high-density lipoprotein (HDL) cholesterol showed non-significant but borderline associations with HHF (P=0.07 and P=0.05, respectively).

Conclusions:

  • Both low and high serum uric acid levels are significant predictors of hypertensive heart failure.
  • High-density lipoprotein cholesterol and fasting blood sugar levels are also associated with the development of HHF.
  • Low-density lipoprotein cholesterol levels did not demonstrate a significant association with hypertensive heart failure in this study.

Keywords:
case-controlheart failurelipidsmatcheduric acid

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