Hyperuricemia and hypertension in working-age people: results of a population study

Abstract

Aim. To study the prevalence of hyperuricemia (HU) and gout depending on hypertension (HTN), as well as to evaluate their associations with mortality in the Russian population.Material and methods. The analysis included data obtained in two cross-sectional studies — ESSE-RF and ESSE-RF2. All study participants were surveyed using a modular designed questionnaire. Serum uric acid (UA) was determined using the uricase method. HU corresponded to a UA >420 µmol/l in men and >360 µmol/l in women. HU without gout was considered asymptomatic HU in the present study. Associations with endpoints were assessed using Cox proportional hazards models with associated hazard ratios.Results. The average prevalence of HU was 18,2%. HU, as expected, predominates among the male cohort — 22,6% vs 15,7%, respectively. The prevalence of asymptomatic HU was 4,4% higher among men compared to women. The prevalence of gout increased with age and averaged 2,6% in the entire population. A high content of UA was revealed in men in the absence of hypertension. The prevalence of HU in women with HTN was 3 times higher than in participants without hypertension. In the male cohort, in the group of hypertension without HU, all-cause and cardiovascular mortality significantly increases, and in the group with hypertension and HU, only all-cause mortality increases. In women, the cardiovascular death risk increased in HTN — hazard ratio 3,98 (95% confidence interval 1,86-8,52). At the same time, in women with HTN and HU, all-cause and cardiovascular death risk increased by 66% and 6,7 times, respectively.Conclusion. Every fifth study participant was diagnosed with HU. The prevalence of HU in hypertensive men was approximately 1,5 times higher than without hypertension. In women with HTN, HU was detected three times more often than without HTN, which may indicate a more pronounced relationship between HTN and HU in women. HU can worsen the HTN prognosis. Thus, monitoring and timely correction of UA levels in hypertensive patients become necessary to improve the prognosis.

Keywords

• hyperuricemia
• gout
• hypertension
• all-cause mortality
• cardiovascular mortality