title: Association between hyperuricemia and incident heart failure among older adults: a propensity-matched study.
abstract: BACKGROUND
  The association between hyperuricemia and incident heart failure (HF) is relatively unknown.
  
  
  METHODS
  Of the 5461 community-dwelling older adults, >or=65 years, in the Cardiovascular Health Study without HF at baseline, 1505 had hyperuricemia (baseline serum uric acid >or=6 mg/dL for women and >or=7 mg/dL for men). Using propensity scores for hyperuricemia, estimated for each participant using 64 baseline covariates, we were able to match 1181 pairs of participants with and without hyperuricemia.
  
  
  RESULTS
  Incident HF occurred in 21% and 18% of participants respectively with and without hyperuricemia during 8.1 years of mean follow-up (hazard ratio {HR} for hyperuricemia versus no hyperuricemia, 1.30; 95% confidence interval {CI}, 1.05-1.60; P=0.015). The association between hyperuricemia and incident HF was significant only in subgroups with normal kidney function (HR, 1.23; 95% CI, 1.02-1.49; P=0.031), without hypertension (HR, 1.31; 95% CI, 1.03-1.66; P=0.030), not receiving thiazide diuretics (HR, 1.20; 95% CI, 1.01-1.42; P=0.044), and without hyperinsulinemia (HR, 1.35; 95% CI, 1.06-1.72; P=0.013). Used as a continuous variable, each 1 mg/dL increase in serum uric acid was associated with a 12% increase in incident HF (HR, 1.12; 95% CI, 1.03-1.22; P=0.006). Hyperuricemia had no association with acute myocardial infarction or all-cause mortality.
  
  
  CONCLUSIONS
  Hyperuricemia is associated with incident HF in community-dwelling older adults. Cumulative data from our subgroup analyses suggest that this association is only significant when hyperuricemia is a marker of increased xanthine oxidase activity but not when hyperuricemia is caused by impaired renal elimination of uric acid.
authors.affiliation: University of Alabama at Birmingham, AL 35294-2041, United States.
authors.forename: O James
authors.initials: OJ
authors.lastname: Ekundayo
authors.forename: Louis J
authors.initials: LJ
authors.lastname: Dell'Italia
authors.forename: Paul W
authors.initials: PW
authors.lastname: Sanders
authors.forename: Donna
authors.initials: D
authors.lastname: Arnett
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Aban
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Love
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Filippatos
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Anker
authors.forename: Donald M
authors.initials: DM
authors.lastname: Lloyd-Jones
authors.forename: George
authors.initials: G
authors.lastname: Bakris
authors.forename: Marjan
authors.initials: M
authors.lastname: Mujib
authors.forename: Ali
authors.initials: A
authors.lastname: Ahmed
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D033461:Hyperuricemia / Q000097:blood / Q000453:epidemiology*; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D057216:Propensity Score; D051437:Renal Insufficiency / Q000097:blood / Q000453:epidemiology; D014527:Uric Acid / Q000097:blood*; D014969:Xanthine Oxidase / Q000378:metabolism
chemical_list: D015415:Biomarkers; D014527:Uric Acid; D014969:Xanthine Oxidase