title: High serum uric acid is associated to poorly controlled blood pressure and higher arterial stiffness in hypertensive subjects.
abstract: BACKGROUND
  Serum uric acid (SUA) has been associated to incident hypertension and increased risk of cardiovascular diseases.
  
  
  METHODS
  Among the 2191 subjects enrolled during the last population survey of the Brisighella Heart Study, we identified 146 new cases of arterial hypertension and 394 treated but uncontrolled hypertensive patients with different levels of SUA. Their hemodynamic characteristics have been compared with those of age- and sex-matched normotensive (N. 324) and controlled hypertensive (N. 470) subjects. Then, by logistic regression analysis, we evaluated which factors were associated with a worse BP control under pharmacological treatment.
  
  
  RESULTS
  SUA levels were significantly higher in untreated hypertensive and uncontrolled hypertensive patients when compared to normotensives and controlled hypertensive patients. Pulse wave velocity (PWV) was significantly higher (p<0.001) in undiagnosed and uncontrolled hypertensive patients, while controlled hypertensive patients had PWV values comparable to normotensive controls. A similar trend has been observed for the augmentation index (AI). A worse BP control was associated with SUA levels (OR 1277, 95% CI 1134-1600 per mg/dL), AI (OR 1066, 95%CI 1041-1092 per unit), and PWV (OR 1201, 95% CI 1089-1423, per m/s), but not with age, body mass index, nor estimated glomerular filtration rate.
  
  
  CONCLUSIONS
  Based on our data, SUA seems to be associated with an inadequate BP control in subjects treated with antihypertensive drugs, and subjects with both uncontrolled BP and relatively high SUA levels have also an increased arterial stiffness that (per se) could be a cause of worse BP control under treatment.
authors: Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy. Electronic address: arrigo.cicero@unibo.it.
authors: Arrigo F G
authors: AF
authors: Cicero
authors: Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy.
authors: Martina
authors: M
authors: Rosticci
authors: Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy.
authors: Federica
authors: F
authors: Fogacci
authors: Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy.
authors: Elisa
authors: E
authors: Grandi
authors: Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy.
authors: Sergio
authors: S
authors: D'Addato
authors: Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy.
authors: Claudio
authors: C
authors: Borghi
authors: Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy.
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D033461:Hyperuricemia / Q000097:blood* / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*; D059289:Vascular Stiffness
chemical_list: D000959:Antihypertensive Agents; D014527:Uric Acid
keywords: Arterial stiffness; Blood pressure control; Renal function; Serum uric acid