title: Prognostic value of serum uric acid: new-onset in and out-of-office hypertension and long-term mortality.
abstract: OBJECTIVE
  Serum uric acid (SUA) has been associated with an increased cardiovascular risk, but no conclusive evidence exists on whether it is an independent risk factor or a reflection of other risk factors to which it is related. We examined the relationship of SUA with a number of cardiovascular variables [including risk factors never evaluated before, such as organ damage and out-of-office blood pressure (BP)], as well as its prognostic relevance in the population.
  
  
  METHODS
  In 2045 participants of the Pressioni Arteriose Monitorate E Loro Associazioni study, we measured, along with SUA, metabolic, renal, and anthropometric variables, left-ventricular mass index, and office, home and ambulatory BP. Cardiovascular and all-cause mortality was assessed over a 16-year follow-up period, and measurements were repeated 10 years after the initial data collection.
  
  
  RESULTS
  Baseline SUA had a near-normal distribution, with a mean value of 4.9 ± 1.3 (SD) mg/dl and a significant direct relationship with BP and metabolic variables, serum creatinine and left-ventricular mass index. It was among the factors independently predicting new-onset home and ambulatory hypertension, the increased risk of developing these conditions for 1  mg/dl increase of SUA after adjustment for all available potential confounders being 34 and 29%, respectively (P = 0.015 and P = 0.014). An increase in SUA of 1  mg/dl also independently predicted cardiovascular and all-cause mortality, the fully adjusted increase in risk being 22% (P = 0.03) and 12% (P = 0.04), respectively.
  
  
  CONCLUSIONS
  In the general population of the Pressioni Arteriose Monitorate E Loro Associazioni study, SUA correlated with a number of cardiovascular risk factors. Nevertheless, it independently predicts new-onset out-of-office hypertension, and long-term cardiovascular and all-cause mortality.
authors.affiliation: aClinica Medica, Dipartimento di Scienze della Salute, Università Milano-Bicocca, Monza, Monza e Brianza bCentro Interuniversitario di Fisiologia Clinica ed Ipertensione - Università Milano-Bicocca, Milano e Pavia, Milan cIstituto Auxologico Italiano, Milan dIRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Bombelli
authors.forename: Irene
authors.initials: I
authors.lastname: Ronchi
authors.forename: Marco
authors.initials: M
authors.lastname: Volpe
authors.forename: Rita
authors.initials: R
authors.lastname: Facchetti
authors.forename: Stefano
authors.initials: S
authors.lastname: Carugo
authors.forename: Raffaella
authors.initials: R
authors.lastname: Dell'oro
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.forename: Guido
authors.initials: G
authors.lastname: Grassi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D001794:Blood Pressure; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000473:pathology; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D007558:Italy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid