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Abstract

The role of serum uric acid as an independent risk factor for cardiovascular and renal morbidity is controversial. A better understanding of its relationship with preclinical organ damage may help clarify the mechanism(s) implicated in the development of early cardiovascular disease.

We evaluated the association between uric acid and the presence and degree of target organ damage in 425 (265 males, 160 females) middle aged, untreated patients with primary hypertension. Left ventricular mass index and carotid intima-media thickness were assessed by ultrasound scan. Albuminuria was measured as the albumin to creatinine ratio in three non consecutive first morning urine samples.

Overall, patients with target organ damage had significantly higher levels of serum uric acid as compared to those without it (presence versus absence of left ventricular hypertrophy, P=0.04; carotid abnormalities, P<0.05; microalbuminuria, P<0.004; and at least 1 versus no organ damage, P<0.03). In women the occurrence and severity of each target organ damage we examined increased progressively from the lower to the upper serum uric acid tertiles (P<0.01). After adjustment for body mass index, age, creatinine clearance, and HDL-cholesterol, each SD increase in serum uric acid entailed a 75% higher risk of having cardiac hypertrophy and a two-times greater risk of having carotid abnormalities.

These results suggest that even mild increases in serum uric acid could play a part in developing preclinical hypertensive damage, especially in women, and support the role of serum uric acid as an independent, modifiable, marker of cardiovascular damage.

Primary Hypertension, Serum Uric Acid, Target Organ Damage
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© American Journal of Hypertension, Ltd. 2005
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