title: Serum uric acid level, longitudinal blood pressure, renal function, and long-term mortality in treated hypertensive patients.
abstract: Uric acid may have a role in the development of hypertension and renal dysfunction. We explored the relationship among longitudinal blood pressure, renal function, and cardiovascular outcomes in a large cohort of patients with treated hypertension. We used data from the Glasgow Blood Pressure Clinic database. Patients with a baseline measure of serum uric acid and longitudinal measures of blood pressure and renal function were included. Mortality data were obtained from the General Register Office for Scotland. Generalized estimating equations were used to explore the relationship among quartiles of serum uric acid, blood pressure, and estimated glomerular filtration rate. Cox proportional hazard models were developed to assess mortality relationships. In total, 6984 patients were included. Serum uric acid level did not influence the longitudinal changes in systolic or diastolic blood pressure but was related to change in glomerular filtration rate. In comparison with patients in the first quartile of serum uric acid, the relative decrease in glomerular filtration rate in the fourth was 10.7 (95% confidence interval, 7.9-13.6 mL/min per 1.73 m(2)) in men and 12.2 (95% confidence interval, 9.2-15.2 mL/min per 1.73 m(2)) in women. All-cause and cardiovascular mortality differed across quartiles of serum uric acid in women only (P<0.001; hazard ratios for all-cause mortality 1.38 [95% confidence interval, 1.14-1.67] for the fourth quartile of serum uric acid compared with the first). Serum uric acid level was not associated with longitudinal blood pressure control in adults with treated hypertension but was related to decline in renal function and mortality in women.
authors.affiliation: Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary & Life Sciences, Western Infirmary, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Jesse
authors.initials: J
authors.lastname: Dawson
authors.forename: Panniyammakal
authors.initials: P
authors.lastname: Jeemon
authors.forename: Lucy
authors.initials: L
authors.lastname: Hetherington
authors.forename: Caitlin
authors.initials: C
authors.lastname: Judd
authors.forename: Claire
authors.initials: C
authors.lastname: Hastie
authors.forename: Christin
authors.initials: C
authors.lastname: Schulz
authors.forename: William
authors.initials: W
authors.lastname: Sloan
authors.forename: Scott
authors.initials: S
authors.lastname: Muir
authors.forename: Alan
authors.initials: A
authors.lastname: Jardine
authors.forename: Gordon
authors.initials: G
authors.lastname: McInnes
authors.forename: David
authors.initials: D
authors.lastname: Morrison
authors.forename: Anna F
authors.initials: AF
authors.lastname: Dominiczak
authors.forename: Sandosh
authors.initials: S
authors.lastname: Padmanabhan
authors.forename: Matthew
authors.initials: M
authors.lastname: Walters
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology*; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D014527:Uric Acid / Q000097:blood*
chemical_list: D000959:Antihypertensive Agents; D014527:Uric Acid
keywords: hypertension; mortality; renal function; uric acid; xanthine oxidase