Serum urate association with hypertension in young adults: analysis from the Coronary Artery Risk Development in Young Adults cohort

Ann Rheum Dis. 2013 Aug;72(8):1321-7. doi: 10.1136/annrheumdis-2012-201916. Epub 2012 Sep 14.

Abstract

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).

Keywords: Arterial Hypertension; Epidemiology; Health services research.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cohort Studies
  • Comorbidity
  • Female
  • Humans
  • Hypertension / blood
  • Hypertension / diagnosis
  • Hypertension / epidemiology*
  • Hyperuricemia / blood
  • Hyperuricemia / diagnosis
  • Hyperuricemia / epidemiology*
  • Male
  • Retrospective Studies
  • Risk Assessment
  • United States / epidemiology
  • Uric Acid / blood*
  • Young Adult

Substances

  • Uric Acid