Abstract
BackgroundThis study examined the effect of serum uric acid (SUA) level and urinary sodium excretion on blood pressure as well as their combined effect on prehypertension in a Korean population.MethodData from the 7th Korea National Health and Nutrition Examination Survey for adults (≥ 19 years of age) were used. The participants were classified into two groups, normotension and prehypertension, according to the JNC-7 definition. Logistic regression was carried out and adjusted for traditionally regarded confounders of blood pressure. All analyses considered a complex sampling design. A multivariate analysis was performed on subgroups defined according to their SUA level and urinary sodium excretion.ResultsThe 4200 participants were divided into normotension (n = 2646) and prehypertension (n = 1554) groups. In the univariate analysis, patient age, male sex, concurrent comorbidity (diabetes mellitus, cardiovascular disease, stroke, dyslipidemia, and chronic kidney disease), uric acid, and urinary sodium excretion were associated with prehypertension. After adjusting for baseline covariates, both the SUA level and urinary sodium excretion were significant predictors of incident prehypertension (SUA, per 1 mg/dL increase, odds ratio [OR] 1.216, 95% confidence interval [95% CI] 1.131–1.309; urinary sodium excretion, per 1 g/day increase, OR 1.067, 95% CI 1.019–1.117). Additionally, simultaneously higher tertiles of SUA and urinary sodium excretion resulted in higher ORs for prehypertension.ConclusionIncreased SUA is a significant risk marker for the development of prehypertension in normotensives. Simultaneously high SUA and urinary sodium excretion amplified the effect on the development of prehypertension. Our findings suggest that lowering SUA levels and reducing sodium intake will contribute to preventing hypertension.
Highlights
This study examined the effect of serum uric acid (SUA) level and urinary sodium excretion on blood pressure as well as their combined effect on prehypertension in a Korean population
Patient age, male sex, concurrent comorbidity, uric acid, and urinary sodium excretion were associated with prehypertension
After adjusting for baseline covariates, both the SUA level and urinary sodium excretion were significant predictors of incident prehypertension (SUA, per 1 mg/dL increase, odds ratio [Odds ratios (OR)] 1.216, 95% confidence interval [95% Confidence intervals (CI)] 1.131–1.309; urinary sodium excretion, per 1 g/day increase, OR 1.067, 95% CI 1.019–1.117)
Summary
This study examined the effect of serum uric acid (SUA) level and urinary sodium excretion on blood pressure as well as their combined effect on prehypertension in a Korean population. The prevalence of hypertension is increasing worldwide, posing a threat to public health. Hypertension is an absolute risk factor for cardiovascular morbidity and mortality, both of which continue to incur high health system costs [1, 2]. A recent Cochrane review and metaanalysis of 34 randomized trials (3230 participants) showed that a mean change of 100 mmol/24 h reduction in urinary sodium reduced systolic and diastolic pressure by 5.4 mmHg and 2.8 mmHg, respectively, in hypertensive individuals, and by 2.4 mmHg and 1.0 mmHg, respectively, in normotensives [4]. Investigations of the relationship between increased sodium intake and prehypertension identified endothelial dysfunction, oxidative stress, inflammation, insulin resistance, and peripheral resistance as causative factors [8, 9]
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