E. Sklyarov, O. Pylypiv, T. Gutor
Danylo Halytsky Lviv National Medical University
Introduction. Arterial hypertension is taking one of the leading places in the structure of cardiovascular morbidity. As you know, obesity, hypodynamia, excessive intake of food salt, hypercholesterolemia, tobacco smoking, excessive use of alcohol are important among the risks of hypertension.
Particular attention deserves not only the generally accepted, but also insufficiently researched predictors of development of hypertension and complications associated with it. Among such factors asymptomatic hyperuricemia should be distinguished, which is considered as an independent risk factor for cardiovascular disease. The relationship between the hyperuricemia and hypertension, obesity, kidney disease, carbohydrate and fat metabolism disorders, diabetes mellitus, insulin resistance and ovarian dysfunction were found.
Aim. To investigate the dependence of the level of uric acid from the body mass index and creatinine in women and men with arterial hypertension.
Materials and methods. The study involved 74 patients with hypertension (37 females and 37 males) aged 30–78 years (mean age – 59.7 ± 1.7 years). Verification of the stage and degree of the arterial hypertension was conducted on the basis of the results of the clinical and instrumental examination and according to the classifications recommended by the experts of the ETG/ETC (2007) and the Ukrainian Association of Cardiologists (2007). The degree of obesity was assessed according to the criteria of the International Diabetes Federation (IDF, 2005) on the basis of the body mass index (BMI). The BMIwas calculated using the Kettle formula: BMI = body weight (kg)/height (m)2. Among the examined patients, 9 had normal body mass, 22 were excessive, 32 were obese (grade I), 8 were obese (grade II), and 3 were obese (III grade). The mean BMI was 30.8 ± 0.7 kg/m2.
For all patients were made echocardiogram, ultrasound examination of internal organs, general clinical examination, blood lipid profile, creatinine and uric acid levels determinations.
Results. It was demonstrated that increased levels of uric acid were combined with the high values of BMI (r = +0.20; p > 0.05) and creatinine (r = +0.76; p < 0.05). Predicted increase of uric acid level was confirmed for 88.6 % of females. Increased levels of uric acid had a weak tendency to correlate with low BMI (r =-0.10; p > 0.05) and high concentration of creatinine in men (r = 0.06; p > 0.05). The prediction of uric acid increase was correct only for 51.9 % of cases for males.
Conclusions. The method of logistic regression determines the dependence of the indicators of the level of the uric acid from BMI and creatinine level in the blood, which has tender differences. For women, there is a significant increase of the level of uric acid in the combination of large values of BMI and high levels of creatinine (correct malformation in 88.6% of cases). Instead, the feminine model was false in men.
References
- Koval’ SM, Reznik LA, Bozhko VV, Pen’kova MY. Hyperuricemia and the Overall Risk of Complications in Hypertensive Patients (according to clinical data). Ukrainian Rheumatological Journal. 2010;4:42-48. (Ukrainian)
- Barskova VG, Nasonova VA, Yakunina IY, et al. About the Severity of the Course of Female Gout. Therapeutic Archive. 2005;5:58-62. (Russian)
- Polovitkina OV, Oschepkova EV, Dmitriev VA, Titov VN. Modern Ideas about the Role of Uric Acid in the Development of Hypertension. Therapeutic Archive. 2011;8:38-41. (Russian)
- Dotsenko MY, Dedova VO, Boev SS et al. Contemporary Ideas on the Mechanisms of Development of Essential Hypertension [Internet]. Arterial Hypertension. 2011; 6. Available from: http://www.mif-ua.com/archive/article/25252. (Ukrainian)
- Hobzey MK, Netyazhenko VZ, Bozhko LI, Vershihora AV, Hidzinska IM, Demchenko NF et al. Unified Clinical Protocol for Primary, Emergency and Secondary (Specialized) Medical Care “Arterial Hypertension”. Practitioner. 2013;2:43-51. (Ukrainian)
- Rodilla E, Pérez-Lahiguera F, Costa JA, González C, Miralles A, Moral D et al. Association between serum uric acid, metabolic syndrome and microalbuminuria in previously untreated essential hypertensive patients. Med Clin (Barc). 2009;132(1):1-6. https://doi.org/10.1016/j.medcli.2008.07.008
- Fessel WJ. Renal outcomes of gout and hyperuricemia. Am J Med. 1979;67:74-82. https://doi.org/10.1016/0002-9343(79)90076-7
- Forman JP, Choi H, Curhan GC. Uric acid and insulin sensitivity and risk of incident hypertension. Arch Intern Med. 2009;169(2):155-162. https://doi.org/10.1001/archinternmed.2008.521
- Grayson РС. Uric acid and hypertension. Curr Pharm Des. 2005;11(32):4139-4143. https://doi.org/10.2174/138161205774913246
- Meisinger C, Koenig W, Baumert J, Döring A. Uric Acid Levels Are Associated With All-Cause and Cardiovascular Disease Mortality Independent of Systemic Inflammation in Men From the General Population. The MONICA/KORA Cohort Study. Arterioscler Thromb Vasc Biol. 2008;28(6):1186-1192. https://doi.org/10.1161/ATVBAHA.107.160184
- Johnson RJ, Feig DI, Herrera-Acosta J, Kang DH. Resurrection of uric acid as a causal risk factor in essential hypertension. Hypertension. 2005;45:18-20. https://doi.org/10.1161/01.HYP.0000150785.39055.e8
- Verdecchia Р, Schillaci G, Reboldi GP. Relation between serum uric acid and risk of cardiovascular disease in essential hypertension. Hypertension. 2000;36:1072-1078. https://doi.org/10.1161/01.HYP.36.6.1072