Effect of uric acid-lowering therapy on blood pressure: systematic review and meta-analysis.
The purpose of this meta-analysis was to determine if uric acid-lowering therapy is associated with a decrease in blood pressure (BP) and serum creatinine levels.



Medline, Cochrane, EMBASE, and Google Scholar databases were searched until 29 June 2016, with keywords: uric-acid-lowering therapy, allopurinol, febuxostat, uricosuric, and BP. Only randomized controlled trials were included. The primary outcomes were reduction in systolic BP (SBP) and diastolic BP (DBP), and secondary was reduction in serum creatinine level.



Patients treated with allopurinol had greater reduction in SBP (standardized difference in means [SDM] = 0.321, 95% confidence interval [CI]: 0.145-0.497, p < 0.001), DBP (SDM = 0.260, 95% CI: 0.102 to 0.417, p = 0.001), and creatinine level (SDM = 0.312, 95% CI: 0.008 to 0.615, p = 0.044) than control patients. Subgroup analysis showed that allopurinol significantly decreased SBP whether or not antihypertensive drugs were being administered; a decrease in DBP was only seen in patients receiving antihypertensive drugs. Low-dose allopurinol (≤300 mg/day) was more effective at reducing SBP than high-dose (>300 mg/day) in patients receiving antihypertensive drugs.



These results support that allopurinol decreases BP and creatinine levels in patients with hyperuricemia. KEY MESSAGES Allopurinol decreases SBP and DPB, and creatinine levels in patients with hyperuricemia. Allopurinol resulted in a significant decrease in SBP in patients with or without treatment of antihypertensive drugs. A dose of allopurinol of ≤300 mg per day might be more effective than a higher dose.
a Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , P.R. China.|b Kidney Disease Immunology Laboratory, The Third Grade Laboratory , State Administration of Traditional Chinese Medicine , Beijing , P.R. China.|c Key Laboratory of Multiple Organ Transplantation , Ministry of Health , Hangzhou , P.R. China.|d Key Laboratory of Nephropathy , Hangzhou , P.R. China.
Li-Hui
LH
Qu
a Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , P.R. China.|b Kidney Disease Immunology Laboratory, The Third Grade Laboratory , State Administration of Traditional Chinese Medicine , Beijing , P.R. China.|c Key Laboratory of Multiple Organ Transplantation , Ministry of Health , Hangzhou , P.R. China.|d Key Laboratory of Nephropathy , Hangzhou , P.R. China.
Hong
H
Jiang
a Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , P.R. China.|b Kidney Disease Immunology Laboratory, The Third Grade Laboratory , State Administration of Traditional Chinese Medicine , Beijing , P.R. China.|c Key Laboratory of Multiple Organ Transplantation , Ministry of Health , Hangzhou , P.R. China.|d Key Laboratory of Nephropathy , Hangzhou , P.R. China.
Jiang-Hua
JH
Chen
D000293:Adolescent; D000368:Aged; D000493:Allopurinol / Q000008:administration & dosage / Q000494:pharmacology*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D003404:Creatinine / Q000097:blood; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D033461:Hyperuricemia / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014527:Uric Acid / Q000037:antagonists & inhibitors*
D000959:Antihypertensive Agents; D004791:Enzyme Inhibitors; D014527:Uric Acid; D000493:Allopurinol; D003404:Creatinine
Allopurinol; blood pressure; gout; hypertension; meta-analysis; renal disease; uric acid