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Temporal relationship between hyperuricemia and hypertension and its impact on future risk of cardiovascular disease

Xue Tian1, Shuohua Chen2, Penglian Wang3

  • 1Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.

European Journal of Internal Medicine
|March 8, 2023
PubMed

Insights

Elevated serum uric acid (SUA) levels may precede hypertension, and blood pressure partially mediates the link between SUA and cardiovascular disease (CVD) risk.

Area of Science:

  • Cardiovascular Medicine
  • Metabolic Disorders
  • Epidemiology

Background:

  • Hyperuricemia and hypertension share a significant correlation, but their temporal sequence and impact on cardiovascular disease (CVD) risk remain unclear.
  • Understanding the causal relationship between high serum uric acid (SUA) and hypertension is crucial for CVD prevention strategies.

Purpose of the Study:

  • To investigate the temporal relationship between hyperuricemia and hypertension.
  • To determine if this temporal relationship is associated with the future risk of cardiovascular events.

Main Methods:

  • Utilized data from 60,285 participants in the Kailuan study, with serum uric acid (SUA), systolic blood pressure (SBP), and diastolic blood pressure (DBP) measured in 2006 and 2010.
  • Employed cross-lagged and mediation analyses to assess the temporal interplay between SUA and blood pressure, and their combined association with incident CVD events post-2010.

Main Results:

  • Serum uric acid significantly predicted future systolic and diastolic blood pressure, more so than blood pressure predicted future SUA.
  • Higher SUA predicted increased blood pressure in participants who later developed CVD.
  • Blood pressure partially mediated the association between SUA and incident CVD, stroke, and myocardial infarction.

Conclusions:

  • Elevated serum uric acid levels likely precede the development of hypertension.
  • Blood pressure acts as a partial mediator in the pathway linking high SUA to incident cardiovascular disease.
Abstract

Keywords:
Blood pressureCardiovascular diseaseCross-lagged analysisMediation analysisSerum uric acid

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