Serum uric acid is associated with new-onset diabetes in hypertensive patients with left ventricular hypertrophy: The LIFE Study.
BACKGROUND
It is unclear whether serum uric acid (SUA) is associated with development of new-onset diabetes (NOD) in patients with hypertension and left ventricular hypertrophy (LVH). The aim of the present investigation was to test the hypothesis that SUA predicts development of NOD in these patients.


METHODS
In the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study, a double-masked, parallel-group design, 9,193 patients with hypertension and electrocardiographic LVH were randomized to losartan- or atenolol-based antihypertensive treatment and followed for a mean of 4.9 years. At baseline, 7,489 patients with available SUA measurements did not have diabetes mellitus and were thus at risk of its development during the study. We used Cox regression analyses to investigate whether SUA predicted development of NOD.


RESULTS
NOD developed in 522 of 7,489 patients. The association between baseline SUA and development of NOD was significant (hazard ratio (HR) 1.29 per s.d. (1.3 mg/dl), 95% confidence interval (CI) 1.18-1.42, P < 0.001) after adjustment for treatment with losartan vs. atenolol, baseline serum glucose, urinary albumin/creatinine ratio, estimated glomerular filtration rate and Framingham risk score, time-varying systolic and diastolic blood pressure, and time-varying LVH by Cornell voltage-duration product and Sokolow-Lyon voltage. In parallel analyses, baseline quartiles of SUA were significantly associated with increasing NOD (HR 1.28, 95% CI 1.18-1.40, P < 0.001). Time-varying SUA was also associated with NOD (HR 1.10 per s.d. [1.3 mg/dl], 95% CI 1.02-1.19, P = 0.015).


CONCLUSIONS
Our analysis suggests that SUA is an independent risk marker for NOD in hypertensive patients with LVH.
Wiik
Benedicte P
BP
Department of Cardiology, Oslo University Hospital, Norway.
Larstorp
Anne C K
AC
Høieggen
Aud
A
Kjeldsen
Sverre E
SE
Olsen
Michael Hecht
MH
Ibsen
Hans
H
Lindholm
Lars
L
Dahlöf
Björn
B
Devereux
Richard B
RB
Okin
Peter M
PM
Wachtell
Kristian
K
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001262:Atenolol / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D017379:Hypertrophy, Left Ventricular / Q000150:complications*; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
D000959:Antihypertensive Agents; D014527:Uric Acid; D001262:Atenolol; D019808:Losartan