Serum urate association with hypertension in young adults: analysis from the Coronary Artery Risk Development in Young Adults cohort
- Angelo L Gaffo1,2,
- David R Jacobs Jr3,4,
- Femke Sijtsma3,
- Cora E Lewis5,
- Ted R Mikuls6,
- Kenneth G Saag2
- 1VA Medical Center, Birmingham, Alabama, USA
- 2Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- 3Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
- 4Department of Nutrition, University of Oslo, Oslo, Blindern, Norway
- 5Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- 6Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Nebraska Medical Center and VA Medical Center, Omaha, Nebraska, USA
- Correspondence to: Dr Kenneth G Saag, Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Alabama at Birmingham, FOT 820 1530 3rd Ave S. Birmingham, AL 35294. USA;
- Accepted 7 August 2012
- Published Online First 14 September 2012
Objective To determine if serum urate concentration is associated with development of hypertension in young adults.
Methods Retrospective cohort analysis from 4752 participants with available serum urate and without hypertension at baseline from the Coronary Artery Risk Development in Young Adults (CARDIA) study; a mixed race (African-American and White) cohort established in 1985 with 20 years of follow-up data for this analysis. Associations between baseline serum urate concentration and incident hypertension (defined as a blood pressure greater or equal to 140/90 or being on antihypertensive drugs) were investigated in sex-stratified bivariate and multivariable Cox-proportional analyses.
Results Mean age (SD) at baseline was 24.8 (3.6) years for men and 24.9 (3.7) years for women. Compared with the referent category, we found a greater hazard of developing hypertension starting at 345 µmol/l (5.8 mg/dl) of serum urate for men and 214 µmol/l (3.6 mg/dl) for women. There was a 25% increase in the hazard of developing hypertension in men (HR1.25 (95% CI 1.15 to 1.36)) per each mg/dl increase in serum urate but no significant increase in women (HR 1.06 (95%CI 0.97 to 1.16)).
Conclusions We found a significant independent association between higher serum urate concentrations and the subsequent hazard of incident hypertension, even at concentrations below the conventional hyperuricaemia threshold of 404 µmol/l (6.8 mg/dl).