Dr. Choi has served on the advisory boards for and received honoraria (less than $10,000) from Takeda Pharmaceuticals.
Hyperuricemia and incident hypertension: A systematic review and meta-analysis
Version of Record online: 28 DEC 2010
Copyright © 2011 by the American College of Rheumatology
Arthritis Care & Research
Volume 63, Issue 1, pages 102–110, January 2011
How to Cite
Grayson, P. C., Kim, S. Y., LaValley, M. and Choi, H. K. (2011), Hyperuricemia and incident hypertension: A systematic review and meta-analysis. Arthritis Care Res, 63: 102–110. doi: 10.1002/acr.20344
- Issue online: 28 DEC 2010
- Version of Record online: 28 DEC 2010
- Accepted manuscript online: 7 SEP 2010 01:06PM EST
- Manuscript Accepted: 25 AUG 2010
- Manuscript Received: 2 JUN 2010
- NIH Training Program in Rheumatic Disease. Grant Numbers: T32-AR-007598, T32-AR-07442
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Number: P60-AR-047785
A novel rodent model and a recent randomized trial of hyperuricemic adolescents with hypertension suggest a pathogenetic role of uric acid in hypertension, but it remains unknown whether these findings would be applicable to adult populations where the larger disease burden exists. We conducted a systematic review and meta-analysis to determine if hyperuricemia was associated with incident hypertension, particularly in various demographic subgroups.
We searched major electronic databases using medical subject headings and keywords without language restrictions (through April 2010). We included prospective cohort studies with data on incident hypertension related to serum uric acid levels. Data abstraction was conducted in duplicate. We analyzed age, sex, and race subgroups.
A total of 18 prospective cohort studies representing data from 55,607 participants were included. Hyperuricemia was associated with an increased risk for incident hypertension (adjusted risk ratio [RR] 1.41, 95% confidence interval [95% CI] 1.23–1.58). For a 1 mg/dl increase in uric acid level, the pooled RR for incident hypertension after adjusting for potential confounding was 1.13 (95% CI 1.06–1.20). These effects were significantly larger in younger study populations (P = 0.02) and tended to be larger in women (P = 0.059). Two studies suggested that the effect may also be larger among African American individuals. Furthermore, later publication year and US-based studies were significantly associated with a lower effect estimate (P values <0.02).
Hyperuricemia is associated with an increased risk for incident hypertension, independent of traditional hypertension risk factors. This risk appears more pronounced in younger individuals and women.