Frequency of Hyperuricemia in Patients with Controlled and Uncontrolled Hypertension
Keywords:
Hyperuricemia, Hypertension, Controlled Hypertension, Uncontrolled Hypertension, Serum Uric Acid, PrevalenceAbstract
OBJECTIVE: To compare the frequency of hyperuricemia between controlled and uncontrolled hypertensive patients.
METHODOLOGY: A cross-sectional study was done by the Department of Medicine at Sohail Trust Hospital Karachi, an associated hospital of Jinnah Medical & Dental College, from December 2024 to March 2025. The study employed non-probability consecutive sampling and involved a sample size of 150 participants. Informed consent was obtained from patients who met the inclusion criteria. Data were entered in the performa. Data analysis was performed using SPSS version 26.0. The Chi-square test was used to compare hyperuricemia between controlled and uncontrolled hypertensive patients at a 5% level of significance, and a P-value ? 0.05 was considered statistically significant.
RESULTS: Mean ± SD of age was 56.11±8.75 years. Mean ± SD of serum uric acid (SUA) was 7.44±2.27 mg/dl. 112 (74.7%) were male, while 38 (25.3%) were female patients. Controlled hypertension was present in 49 (32.7%), while uncontrolled hypertension was present in 101 (67.3%) patients. Hyperuricemia was found in 107 (71.3%) patients, among them 35 (23.3%) had controlled hypertension, while 72 (48.0%) had uncontrolled hypertension, and the p-value was determined as not statistically significant (P=0.986).
CONCLUSION: Hyperuricemia was highly prevalent in our population, although no significant association was observed between SUA levels and blood pressure control status. Larger multicenter studies with broader clinical parameters are recommended to explore this association further and determine its clinical significance.
References
1. Melgarejo ID, Maestre GE, Thijs L, Asayama K, Boggia J, Casiglia E et al. Prevalence, treatment, and control rates of conventional and ambulatory hypertension across 10 populations in 3 continents. Hypertension. 2017; 70(1): 50-8. doi:10.1161/YPERTENSIONAHA.117.09188
2. Zhou B, Perel P, Mensah GA, Ezzati M. Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension. Nat Rev Cardiol. 2021; 18(11): 785–802. doi: 10.1038/s41569-021-00559-8.
3. Wang C, Yuan Y, Zheng M, Pan A, Wang M, Zhao M et al. Association of age of onset of hypertension with cardiovascular diseases and mortality. J Am Coll Cardiol. 2020; 75(23): 2921–2930. doi:10.1016/j.jacc.2020.04.038.
4. Chew NWS, Ng CH, Tan DJH, Kong G, Lin C, Chin YH et al. The global burden of metabolic disease: Data from 2000 to 2019. Cell Metab. 2023; 35: 414–428. doi:10.1016/j.cmet.2023.02.003.
5. Lu WL, Yuan JH, Liu ZY, Su ZH, Shen YC, Li SJ et al. Worldwide trends in mortality for hypertensive heart disease from 1990 to 2019 with projection to 2034: data from the global burden of disease 2019 study. Eur J Prev Cardiol. 2024; 31(1): 23–37. doi:10.1093/eurjpc/zwad262
6. Kario K, Okura A, Hoshide S, Mogi M. The WHO Global report 2023 on hypertension warning the emerging hypertension burden in globe and its treatment strategy. Hypertens Res. 2024; 47: 1099–1102. doi:10.1038/s41440-024-01622-w.
7. Soletsky B, Feig DI. Uric acid reduction rectifies pre-hypertension in obese adolescents. Hypertension. 2012; 60(5): 1148-56. doi:10.1161/HYPERTENSIONAHA.112.196980.
8. Beattie CJ, Fulton RL, Higgins P, Padmanabhan S, McCallum L, Walters MR et al. Allopurinol initiation and change in blood pressure in older adults with hypertension. Hypertension. 2014; 64(5): 1102-7. doi:10.1161/HYPERTENSIONAHA.114.03953.
9. Mazzali M, Hughes J, Kim YG, Jefferson JA, Kang DH, Gordon KL et al. Elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism. Hypertension. 2001; 38(5): 1101-6. doi:10.1161/hy1101.092839.
10. Kang DH, Park SK, Lee IK, Johnson RJ. Uric acid-induced C-reactive protein expression: implication on cell proliferation and nitric oxide production of human vascular cells. J Am Soc Nephrol. 2005; 16(12): 3553-62. doi:10.1681/ASN.2005050572.
11. Borghi C, Agnoletti D, Cicero AFG, Lurbe E, Virdis A. Uric acid and hypertension: a review of evidence and future perspectives for the management of cardiovascular risk. Hypertension. 2022; 79(9): 1927-36. doi:10.1161/HYPERTENSIONAHA.122.17956
12. Shahid R, Hussain M, Ghori MU, Bilal A, Awan FR. Association of hyperuricemia with metabolic syndrome and its components in an adult population of Faisalabad, Pakistan. Nutr Metab Cardiovasc Dis. 2024; 34(6): 1554–8. doi:10.1016/j.numecd.2024.03.017
13. Shah SS, Iqbal U, Ahmad E. Frequency of hyperuricemia in hypertensive patients and its association with age of patient. Pak Armed Force Med J. 2021; 71(1): 304-8. doi:10.51253/pafmj.v71i1.2808.
14. Cho J, Kim C, Kang DR, Park JB. Hyperuricemia and uncontrolled hypertension in treated hypertensive patients: K-MetS Study. Medicine (Baltimore). 2016; 95(28): e4177. doi:10.1097/MD.0000000000004177
15. Gustafsson D, Unwin R. The pathophysiology of hyperuricaemia and its possible relationship to cardiovascular disease, morbidity and mortality. BMC Nephrol. 2013; 14(1): 1-9. doi:10.1186/1471-2369-14-164.
16. Doyle AE. Hypertension and vascular disease. Am J Hypertens. 1991; 4(2_Pt_2): 103S-6S. doi:10.1093/ajh/4.2.103s.
17. Charles L, Triscott J, Dobbs B. Secondary hypertension: discovering the underlying cause. Am Fam Physician. 2017; 96(7): 453-61
18. Iqbal M, Akram M, Rashid A, Zainab R, Laila U, Khalil MT, et al. Prevalence of hypertension and associated co-morbidities in Pakistan. Mathews J Nurs Healthcare. 2023; 5(1): 1-7.
19. Kuwabara M. Hyperuricemia, cardiovascular disease, and hypertension. Pulse. 2016; 3(3-4): 242-52. doi:10.1159/000443769.
20. Ito H, Antoku S, Furusho M, Shinozaki M, Abe M, Mifune M et al. The prevalence of the risk factors for atherosclerosis among type 2 diabetic patients is greater in the progressive stages of chronic kidney disease. Nephron Extra. 2013; 3(1): 66–72. doi:10.1159/000353592.
21. Raja S, Kumar A, Aahooja RD, Thakuria U, Ochani S, Shaukat F. Frequency of hyperuricemia and its risk factors in the adult population. Cureus. 2019; 11(3): e4198. doi:10.7759/cureus.4198.
22. Bhosale A, Khedkar S, Khade SK, Reddy MM. Study of serum uric acid levels in essential hypertension. Int J Health Sci (Qassim). 2022; 6(S7): 3528-36. doi:10.53730/ijhs.v6nS7.12511.
23. Rajadhyaksha A, Sarate N, Raghorte N, Ingawale S. A clinical profile of patients with hyperuricemia and the relationship between hyperuricemia and metabolic syndrome: a cross-sectional study at a tertiary hospital in the Indian population. J Assoc Physicians India. 2022 May; 70(5): 11-2. doi:10.0102/japi.2022.05.
24. Farhadi F, Aliyari R, Ebrahimi H, Hashemi H, Emamian MH, Fotouhi A. Prevalence of uncontrolled hypertension and its associated factors in 50–74 years old Iranian adults: a population-based study. BMC Cardiovasc Disord. 2023; 23: 318. doi:10.1186/s12872-023-03357-x.
25. Amare F, Hagos B, Sisay M, Molla B. Uncontrolled hypertension in Ethiopia: a systematic review and meta-analysis of institution-based observational studies. BMC Cardiovasc Disord. 2020 Dec; 20: 1-9. doi:10.1186/s12872-020-01414-3.
26. Liu C, Qiu D, Zhang M, Hou J, Lin J, Liao H. Association of hyperuricemia and hypertension phenotypes in hypertensive patients without uric acid-lowering treatment. Clin Exp Hypertens. 2021; 43(6): 516-21. doi:10.1080/10641963.2021.1907397.
27. Borghi C, Tubach F, De Backer G, Dallongeville J, Guallar E, Medina J et al. Lack of control of hypertension in primary cardiovascular disease prevention in Europe: results from the EURIKA study. Int J Cardiol. 2016; 218: 83–88. doi:10.1016/j.ijcard.2016.05.044
28. Cicero AF, Rosticci M, Fogacci F, Grandi E, D’Addato S, Borghi C, Brisighella Heart Study Group. High serum uric acid is associated to poorly controlled blood pressure and higher arterial stiffness in hypertensive subjects. Eur J Intern Med. 2017; 37: 38–42. doi:10.1016/j.ejim.2016.07.026.
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