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AB0630 Gout and hypertension. role of hyperuricemia in the development of hypertension.
  1. E. Mikhnevich1,
  2. C. Mytnik1
  1. 1UNIVERSITY OF MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, SERVICE OF RHEUMATOLOGY, Minsk, Belarus

Abstract

Background The most of patients with gout have various associated diseases, from which hypertension (HTN) has an important prognostic value. The role of hyperuricemia (HUE) in the development of HTN remains a subject of the discussions.

Objectives To study the factors, which participate in the formation of HTN in gout; to determine the associations between the risk factors, parameters of severity of HTN and uricemia.

Methods 358 patients with the gouty arthritis (GA), admitted to the Rheumatology Unit during 2009-2012, filled classification criteria of the acute GA (1977, ACR). 285 (79,6%) patients had HTN. The co-morbidities: ischemic heart disease -120 (33,5 %) patients, diabetes-56 (15,6 %) patients, chronic kidney disease - 182 (50,8 %) patients, vascular coronary and cerebral accidents – 41 (11,5 %) patients. We chose 73 patients from the group with primary gout and concomitant HTN (group HTN+) and 73 patients (20,4 %) without HTN ( group HTN-), comparable in sex, age and duration of gout. Characteristics of gout and HTN were compared between the groups HTN+ and HTN-. We studied the correlation links between the serum levels of acid uric and the risk factors, parameters of severity of HTN.

Results Among patients with HTN+ diabetes was more often observed, than in group without HTN (OR-2,6; 95%CI, 0,98-6,92; p< 0,05). Compared with patients from group HTN-, patients from group HTN+ had higher rates of ischemic heart disease (OR-3,29; 95 %Cl, 1,5-7,2; p< 0,001). In the patients of group HTN+ we also found statistically higher number of the cases of excess weight and obesity (OR-5,54; 95%CI, 4,90-6,25; p<0,05). No differences between the groups were noted in the serum levels of uric acid (HTN- 576±180 mmol/l vs HTN+ 537±123 mmol/l, p> 0,05). Glomerular filtration rate and the level of the serum creatinine were similar in both groups. We defined the direct statistically significant correlation links between the serum levels of acid uric and triglycerides in the general group (r=0,66) and in the group HTN- (r=0,52). No parameters of characteristics of HTN were correlated with the serum level of acid uric.

Conclusions In clinical setting the majority of patients with gouty arthritis have hypertension- 79,6%. The serum level of uric acid in patients with gout is closely linked with the serum level of triglycerides. The development of hypertension in patients with gout is associated with diabetes, excess weight and obesity as well as ischemic heart disease. The direct role of hyperuricemia was not confirmed in it.

Disclosure of Interest None Declared

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