Longitudinal association between serum uric acid level and carotid atherosclerotic plaques in patients with new cases of hypertension

Abstract

Abstract Objective To reveal the relationship between uric acid level and carotid atherosclerotic plaques in hypertensive subjects in randomized urban population according to 10-years prospective study. Design and methods A 10-years prospective study included 3,500 randomized individuals living in the district of Vitebsk (2007/2008 - 2017/2018). The coverage of the survey was 97,9% (3427 participants). There was revealed 2170 persons with normal blood pressure. 1862 of them were examined on the second stage in 2012/2013 (coverage of the survey was 85,8%). 286 new cases of hypertension were revealed and they had significant positive relationship with the IV quartile of uric acid level (≥339 μmol/l). A 10-years prospective analysis was provided in 2017/2018 and included 145 randomized subjects with hypertension diagnosed on the second stage of the study. Specially developed registration form was filled in for all the participants and it included socio-demographic data, standard questionnaires for detection of cardiovascular risk factors, anthropometry, blood pressure measurements, electrocardiography, blood chemistry, ultrasound examination of brachiocephalic arteries and echocardiography. Results According to the results of 10-years prospective study serum uric acid level ≥339 μmol/l, revealed at the start of the study, is a predictor of the detection of carotid atherosclerotic plaques in 2017/2018 in subjects with new cases of hypertension (df=1; χ2 Wald=6,63; p<0,05) adjusted for age and gender. Cross-sectional analysis of these subjects showed that the level of uric acid, regardless of age and gender, is associated with the level of triglycerides (p<0,001), apo B (p<0,001), apo A1 (p<0,05), LDL (p<0,05), VLDL (p<0,05), HDL (p<0,05), non-HDL-C (p<0,05), total cholesterol (p<0,05), high-sensitivity CRP (p<0,05), TNF-α (p<0,05), apoB/apoA1 ratio (p<0,05), glycated hemoglobin percentage (p<0,05), body mass index (p<0,001), waist circumference (p<0,05), metabolic syndrome (p<0,05) and alcohol abuse (p<0,05). In stepwise multiple linear regression model the most significant of these factors were the level of triglycerides (β=0,23, p<0,05), alcohol abuse (β=0,18, p<0,05), body mass index (β=0,18, p<0,05), apoB/apoA1 ratio (β=0,17, p<0,05) and level of high-sensitivity CRP (β=0,15, p<0,05). Conclusions Serum uric acid level ≥339 μmol/l predicted detection of carotid atherosclerotic plaques in patients with new cases of hypertension in 10-years prospective study. The most significant factors, regardless of age and gender, associated with serum uric acid levels in these patients were level of triglycerides, alcohol abuse, body mass index, apoB/apoA1 ratio and level of high-sensitivity C-reactive protein. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Republican Scientific and Practical Centre of Cardiology