Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study.
BACKGROUND
Hyperuricemia is associated with risk for cardiovascular disease and death. However, the role of uric acid independent of established risk factors is uncertain.


OBJECTIVE
To examine the relation of serum uric acid level to incident coronary heart disease, death from cardiovascular disease, and death from all causes.


METHODS
Community-based, prospective observational study.


METHODS
Framingham, Massachusetts.


METHODS
6763 Framingham Heart Study participants (mean age, 47 years).


METHODS
Serum uricacid level at baseline (1971 to 1976); event rates per 1000 person-years by sex-specific uric acid quintile.


RESULTS
During 117,376 person-years of follow-up, 617 coronary heart disease events, 429 cardiovascular disease deaths, and 1460 deaths from all causes occurred. In men, after adjustment for age, elevated serum uric acid level was not associated with increased risk for an adverse outcome. In women, after adjustment for age, uric acid level was predictive of coronary heart disease (P = 0.002), death from cardiovascular disease (P = 0.009), and death from all causes (P = 0.03). After additional adjustment for cardiovascular disease risk factors, uric acid level was no longer associated with coronary heart disease, death from cardiovascular disease, or death from all causes. In a stepwise Cox model, diuretic use was identified as the covariate responsible for rendering serum uric acid a statistically nonsignificant predictor of outcomes.


CONCLUSIONS
These findings indicate that uric acid does not have a causal role in the development of coronary heart disease, death from cardiovascular disease, or death from all causes. Any apparent association with these outcomes is probably due to the association of uric acid level with other risk factors.
National Heart, Lung, and Blood Institute's Framingham Heart Study, Massachusetts 01702, USA.
B F
BF
Culleton
M G
MG
Larson
W B
WB
Kannel
D
D
Levy
D017677:Age Distribution; D000375:Aging / Q000097:blood; D001900:Boston / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000097:blood* / Q000401:mortality*; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011446:Prospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D015996:Survival Rate; D014527:Uric Acid / Q000097:blood*
D014527:Uric Acid