Gender differences in the association between elevated serum uric acid,not diuretic-induced,and cardiovascular disease in untreated hypertension patients

FAN Xiao-han; WU Yan; SUN Kai; WU Hai-ying; ZHOU Xian-liang; HUI Ru-tai

摘要：Background Studies have been inconsistent regarding whether hyperuricemia, either diuretic- or non diuretic-induced, is an independent risk factor for cardiovascular events. The study investigated the association of cardiovascular disease with diuretic- and non diuretic-induced elevated serum uric acid. Methods A community-based cross-section study was conducted in 5,235 treated and untreated hypertensive patients aged 40-75 years.Conventional risk factors,serum uric acid and the presence of cardiovascular disease were determined.Hyperuricemia was defined as serum uric acid levels ≥420 Rmol/L in men or ≥360 μmol/L in women.Results Hyperuricemia was more common in men than in women(21.5％vs.10.2％,P<0.001).After adjustment for age and other conventional risk factors,hyperuricemia was associated with metabolic syndrome,decreased creatinine clearance,and use of diuretics in both genders,as well as age in women and alcohol consumption in men.The presence of coronary artery disease or stroke increased significantly with the increase of quartiles of serum uric acid(8.0％,1 1.0％,13.4％,and 16.8％,respectively,P<0．01),and the highest serum uric acid quartile was associated with a 1.8-fold risk for cardiovascular disease(OR:1.83,95％CI:1.24—2.71)in untreated women.But this association was not observed in untreated men as well as in treated patients using diuretics in both genders. Conclusions Hyperuricemia is markedly associated with metabolic syndrome,decreased creatinine clearance,use of diuretics besides alcohol consumption in men and age in women.Elevated serum uric acid,but not that diuretic-induced,may be associated with increased the risk of cardiovascular disease in untreated hypertensive women.