• Eur. J. Intern. Med. · May 2023

    Temporal relationship between hyperuricemia and hypertension and its impact on future risk of cardiovascular disease.

    • Xue Tian, Shuohua Chen, Penglian Wang, Qin Xu, Yijun Zhang, Xiaoli Zhang, Shouling Wu, Yanxia Luo, and Anxin Wang.
    • Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
    • Eur. J. Intern. Med. 2023 May 1; 111: 828982-89.

    BackgroundAlthough hyperuricemia and hypertension are significantly correlated, their temporal relationship and whether this relationship is associated with risk of cardiovascular disease (CVD) are largely unknown. This study aimed to examine temporal relationship between hyperuricemia and hypertension, and its association with future risk of CVD.MethodsThis study included 60,285 participants from the Kailuan study. Measurement of serum uric acid (SUA), systolic and diastolic blood pressure (SBP and DBP) were obtained twice at 2006 (baseline) and 2010. Cross-lagged and mediation analysis were used to examine the temporal relationship between hyperuricemia and hypertension, and the association of this temporal relationship with CVD events risk after 2010.ResultsAfter adjusting for covariates, the cross-lagged path coefficients (β1) from baseline SUA to follow-up SBP and DBP were significantly greatly than path coefficients (β2) from baseline SBP and DBP to follow-up SUA (β1=0.041 versus β2=0.003; Pdifference<0.0001 for SBP; β1=0.040 versus β2=0.000; Pdifference<0.0001 for DBP). The path coefficients from baseline SUA to follow-up SBP and DBP in group with incident CVD were significantly greatly than that in group without incident CVD (Pdifference of β1 in the two groups was 0.0018 for SBP and 0.0340 for DBP). Furthermore, SBP and DBP partially mediated the effect of SUA on incident CVD, the mediation effect was 57.64% for SBP and 46.27% for DBP. Similar mediated results were observed for stroke and myocardial infarction.ConclusionIncreased SUA levels probably precede elevated BP, and BP partially mediates the pathway from SUA to incident CVD.Copyright © 2023 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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