[Follow-up study of programmed intervention of hyperuricemia in the prevention and treatment of cardiovascular morbid change].
OBJECTIVE
To investigate the beneficial impact of programmed hyperuricemic intervention upon the alterations of metabolic parameters and the prevention of cardiovascular morbid change.


METHODS
A total of 531 subjects of hyperuricemia were randomly divided into two groups: intervention group and control group. There was a 36-month follow-up by this prospective study. The intervention group was managed and followed up while the control group received only the baseline and final assessments. The improved way of life, changes of metabolic parameters and sub-clinical cardiovascular lesions were compared between two groups.


RESULTS
(1) Except for smoking and drinking habits, such lifestyle aspects as low-purine diet, low-fat diet, high-salt control and regular exercise had improved significantly and their percentages increased 37.1%, 26.2%, 25.7%, 24.8% respectively after management in the intervention group (P < 0.01). Except for low-purine and low-fat diets, the lifestyle aspects had not improved significantly after follow-up in the control group. The incremental percentages of high-salt control and regular exercise were 2.2% and 2.1% respectively and there was no statistical difference (P > 0.05). (2) The pre-intervention and post-intervention levels of uric acid, body mass index, waist circumference, triglycerides and blood pressure were (449 +/- 3) vs (410 +/- 3) mmol/L, (3.62 +/- 0.30) vs (1.98 +/- 0.02) mmol/L, (93.8 +/- 0.6) vs (90.2 +/- 0.5) cm, (27.13 +/- 0.19) vs (25.67 +/- 0.17) kg/m(2), (129.1 +/- 1.0) vs (123.8 +/- 0.6) mm Hg and (80.7 +/- 0.7) vs (78.5 +/- 0.8) mm Hg respectively (P < 0.01). Those for high density lipoprotein and blood glucose were (1.06 +/- 0.02) vs (1.12 +/- 0.18) mmol/L and (5.54 +/- 0.08) vs (5.36 +/- 0.04) mmol/L respectively (P < 0.05). The levels of cholesterol showed no decline (P > 0.05). During follow-up, the level of blood pressure, body mass index, blood glucose and triglyceride in the control group had been reduced (P < 0.05); the level of other metabolic indicators did not (P > 0.05). (3) The pre-intervention and post-intervention levels of hs-CPR and B-type natriuretic peptide were (1.62 +/- 0.12) vs (1.33 +/- 0.11) mg/L and (6.76 +/- 0.10) vs (5.88 +/- 0.17) ng/L respectively. Compared with the control group, there were statistical differences (P < 0.01). The proportions of positive lesions of carotid artery ultrasound type B, ocular fundus disease and cardiac ultrasound in intervention group were 3.81%, 5.71%, 2.85% vs 12.56%, 13.66%, 10.92% in control group (P < 0.01). The proportions of positive incidences of ECG ST-T changes, treadmill exercise test and coronary CT in intervention group was 5.23%, 0.92%, 0 vs 12.02%, 4.91%, 2.73% in control group (P < 0.05).


CONCLUSIONS
Programmed hyperuricemic intervention can improve the lifestyles of patients and optimize their metabolic parameters and cardiovascular lesions. These measures are of great importance in the prevention and treatment of sub-clinical cardiovascular morbid change.
Zhu
Wen-hua
WH
Department of General Practice, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou 310016, China.
Fang
Li-zheng
LZ
Chen
Li-ying
LY
Chen
Zhou-wen
ZW
Dai
Hong-lei
HL
Chen
Jian-hua
JH
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D018479:Early Intervention, Educational; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033461:Hyperuricemia / Q000628:therapy*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome