title: Serum uric acid and blood pressure in children at cardiovascular risk.
abstract: OBJECTIVE
  Hyperuricemia has been shown to be a strong correlate of hypertension in children. However, the complex interaction between serum uric acid (UA), systemic blood pressure (BP), and possibly confounding factors has been elucidated only in part.
  
  
  METHODS
  We evaluated office BP as well as clinical and biohumoral parameters in a cross-sectional cohort of 501 children (280 boys and 221 girls) aged between 6 and 18 years (mean = 10.8 years) consecutively referred for cardiovascular risk assessment.
  
  
  RESULTS
  Overall, 156 (31.1%) were normotensive, 122 (24.4%) showed transient hypertension, 87 (17.4%) had prehypertension, and 136 (27.1%) had hypertension. Altogether 33.3% and 40.5% of the study group were overweight or obese, respectively. There was a trend toward greater weight and waist circumference and higher BMI, Homeostasis Model Assessment index, and UA levels as the BP categories rose. Moreover, the prevalence of pubertal children, obesity, and waist-to-height ratio above 0.50 progressively increased from lower to upper BP categories. After adjusting for puberty, gender, BMI (z-score), Homeostasis Model Assessment index, and renal function, UA was found to be directly related to systolic and diastolic BP values (P = .03). Using normotensive children for comparison, the risk of showing prehypertension or hypertension increased by at least 50% for each 1 mg/dL UA increase (P < .01), whereas it doubled for children in the top gender-specific UA quartile (P < .03).
  
  
  CONCLUSIONS
  Increased UA levels showed an independent predictive power for the presence of higher BP levels among a cohort of children at relatively high cardiovascular risk.
authors.affiliation: University of Genoa and IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la ricerca sul Cancro, Genova, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Viazzi
authors.forename: Laura
authors.initials: L
authors.lastname: Antolini
authors.forename: Marco
authors.initials: M
authors.lastname: Giussani
authors.forename: Paolo
authors.initials: P
authors.lastname: Brambilla
authors.forename: Sara
authors.initials: S
authors.lastname: Galbiati
authors.forename: Silvana
authors.initials: S
authors.lastname: Mastriani
authors.forename: Andrea
authors.initials: A
authors.lastname: Stella
authors.forename: Roberto
authors.initials: R
authors.lastname: Pontremoli
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Valsecchi
authors.forename: Simonetta
authors.initials: S
authors.lastname: Genovesi
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology*; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology*; D033461:Hyperuricemia / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology*; D007333:Insulin Resistance / Q000235:genetics / Q000502:physiology; D007558:Italy; D007677:Kidney Function Tests; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology; D010641:Phenotype; D011627:Puberty / Q000502:physiology; D012306:Risk; D012737:Sex Factors; D014527:Uric Acid / Q000097:blood*; D055105:Waist Circumference / Q000502:physiology
chemical_list: D014527:Uric Acid
keywords: HOMA index; children; hypertension; obesity; pre-hypertension; uric acid