title: Asymptomatic hyperuricemia is a strong risk factor for resistant hypertension in elderly subjects from general population.
abstract: OBJECTIVE
  In clinical practice, patient characteristics predicting resistant hypertension (RH) include higher blood pressure levels, left ventricular hypertrophy, older age, obesity, chronic kidney disease and diabetes. On the contrary little is known about the role of serum uric acid (SUA) as a risk factor for RH in subjects from general population.
  
  
  METHODS
  580 elderly subjects aged ≥65 years were enrolled in the Risk Of Vascular complications Impact of Genetics in Old people (ROVIGO) study. RH was defined as the failure to maintain blood pressure values below 140mmHg (systolic) and 90mmHg (diastolic) despite therapeutic interventions that include appropriate lifestyle measures plus adherence to treatment with full doses of at least three antihypertensive drugs, including a diuretic. RH was confirmed using 24-h ambulatory blood pressure measurement. Hyperuricemic was defined as the subjects having SUA ≥6.8mg/dl or taking uricosuric drugs. Gender-specific odds ratio (OR) for RH was calculated by logistic regression analysis.
  
  
  RESULTS
  The prevalence of RH was 5.7% in the cohort and was higher in women (8.3%) than in men (3.0%, p<0.05). Independent of chronic kidney disease (OR 3.89, 95% confidence interval 1.49-10.1), hyperuricemia predicted resistant hypertension in women (odds ratio 3.11, 95% confidence intervals 1.06-9.1, p=0.03) but not in men.
  
  
  CONCLUSIONS
  In elderly women from the general population, an SUA value of ≥6.8mg/dl triples the risk of RH. SUA assessment should be recommended to better define the pattern of risk associated with RH.
authors.affiliation: Hypertension Centre, Hospital Santa Maria della Misericordia, Rovigo, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Mazza
authors.affiliation: Hypertension Centre, Internal Medicine and Geriatrics, Hospital San Donato, Arezzo, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Lenti
authors.affiliation: Department of Internal Medicine, Hospital Santa Maria della Misericordia, Rovigo, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Schiavon
authors.affiliation: Department of Internal Medicine, Hospital Santa Maria della Misericordia, Rovigo, Italy.
authors.forename: Alvise Del
authors.initials: AD
authors.lastname: Monte
authors.affiliation: Department of Drug Discovery and Pharmaceutical Sciences, Medical University of South Carolina, USA.
authors.forename: Danyelle M
authors.initials: DM
authors.lastname: Townsend
authors.affiliation: Department of Internal Medicine, Hospital Santa Maria della Misericordia, Rovigo, Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Ramazzina
authors.affiliation: Departement of Nuclear Medicine, Hospital Santa Maria della Misericordia, Rovigo, Italy. Electronic address: Domenico.rubello@libero.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.affiliation: Department of Internal Medicine, University of Padova, Padova, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Casiglia
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy / Q000209:etiology*; D033461:Hyperuricemia / Q000097:blood / Q000150:complications*; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D014527:Uric Acid / Q000097:blood
chemical_list: D000959:Antihypertensive Agents; D014527:Uric Acid
keywords: Cardiovascular risk; Epidemiology; Resistant hypertension; Uric acid