title: Elevated uric acid and obesity-related cardiovascular disease risk factors among hypertensive youth.
abstract: BACKGROUND
  Uric acid (UA) is associated with high blood pressure in adolescents and with left ventricular hypertrophy (LVH) and cardiovascular disease (CVD) in adults. We sought to determine if UA is independently associated with CVD risk factors and left ventricular mass (LVM) over time in hypertensive youth.
  
  
  METHODS
  This was a 1-year prospective observational study of hypertensive children aged 3-19 years. Cross-sectional and longitudinal associations of serum UA with CVD risk factors and LVM were explored.
  
  
  RESULTS
  Of the 49 children who completed both the baseline and 12-month assessments, at baseline the mean age was 13.8 years and mean UA was 5.5 mg/dL; 24% had elevated UA, 51% were overweight/obese and 39% had LVH. Measures of adiposity, low high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, LVM and LVH were all significantly associated with elevated UA at baseline, but not with change over time. Each 1 mg/dL increase in baseline UA was associated with a 2.5 g/m(2.7) increase in the LVM index at follow-up (95% confidence interval 0.64, 4.39; p = 0.01); after adjustment for age, sex, race, body mass index z-score, change in UA, time, blood pressure and medication use, this association was no longer significant.
  
  
  CONCLUSIONS
  Hypertensive children with elevated UA have a higher prevalence of obesity-related CVD risk factors. Among hypertensive children, UA may be a marker of adiposity and not an independent CVD risk factor.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Lauren D
authors.initials: LD
authors.lastname: Reschke
authors.affiliation: Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Edgar R
authors.initials: ER
authors.lastname: Miller
authors.affiliation: Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Fadrowski
authors.affiliation: Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Lauren F
authors.initials: LF
authors.lastname: Loeffler
authors.affiliation: Division of Pediatric Cardiology, Oregon Health and Science University, Portland, OR, USA.
authors.forename: Kathryn W
authors.initials: KW
authors.lastname: Holmes
authors.affiliation: Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Appel
authors.affiliation: Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. tbrady8@jhmi.edu.
authors.forename: Tammy M
authors.initials: TM
authors.lastname: Brady
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology*; D033461:Hyperuricemia / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000503:physiopathology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*; D055815:Young Adult
chemical_list: D014527:Uric Acid
keywords: Blood pressure; Cardiovascular disease; Children; Left ventricular hypertrophy; Longitudinal; Obesity; Uric acid