Serum Uric Acid And Target Organ Damage In Adult Hypertensive Patients

Aims: To analyze the relationship between hyperuricemia and target organ damage in adult hypertensive patients in the center of Tianjin Medical University General Hospital.The patients were divided into different subgroups by gender and course of hypertension,thus we could explore the difference between different subgroups.Methods: This study is a cross-sectional study,collecting and screening hypertensive patients from January to December 2015 in the adult medical examination population of Tianjin Medical University General Hospital Health Management Center.918 hypertensive patients aged 26-67 years were selected(371 cases with disease course ?1 year,547 cases with disease course <1 year;677 cases of male patients with hypertension,241 cases of female patients with hypertension).All selected patients were recorded in details:(1)general situation: gender,age,nationality,occupation,marital status etc.(2)lifestyle and habits: eating,sleeping,smoking,drinking,etc.(3)past medical history: with or without hypertention/diabetes/metabolic syndrome/ cerebrovascular disease,and other medical history.(4)physical examination: blood pressure,height and weight were measured.(5)Biochemical detection: Subjects were fasting for 8 to 12 hours,the next morning in Tianjin Medical University General Hospital examination center,for detection of serum lipid levels,serum creatinine,fasting plasma glucose,serum uric acid etc.Collected early morning urine as urine sample,then conducted routine urine test.(6)Auxiliary examination: Resting electrocardiogram was recorded on a 12-lead electrocardiogram.Bilateral carotid intima-media thickness(CIMT)and brachial-ankle pulse wave velocity(ba PWV)were measured by color Doppler sonography.Left ventricular parameters were measured by echocardiography.The subjects were divided into groups of disease course ?1 year and disease course <1 year;male hypertension group and female hypertension group.Then each group was divided into A group and B group(A group as hyperuricemia group,B group as uric acid normal group).The normality test was used for data,if consistent with the normal distribution with mean±standard deviation((?)±S),among groups were compared with student's t-test;if not in line with the normal distribution,then with the median and interquartile range,Mann Whitney U test was used.Count data with the percentage(%),the two groups were compared by ?2 test or Fisher exact test.Linear regression analyses were used to analyze the correlation between serum uric acid level and target organ damage in different hypertensive patients.Logistic regression analyses were used to analyze the relationship between hyperuricemia and target organ damage in different hypertensive patients.Statistical signifcance was set at a 2-tailed P<0.05.All analyses were performed using the SPSS 19.0.Results: 1.After adjusting for age,gender,BMI,systolic blood pressure,diastolic blood pressure,blood lipids and fasting blood glucose,the level of serum uric acid was negatively correlated with e GFR in all hypertensive patients(P<0.01,?=-0.298).There was a negative correlation between serum uric acid level and e GFR in hypertensive patients with disease course ?1 year(P<0.01,?=-0.298),and positive correlation with ba PWV(P=0.029,?=0.099),but no correlation with LVMI?CIMT(P>0.05).Serum uric acid level was negatively correlated with e GFR in hypertensive patients with disease course <1 year(P<0.01,?=-0.338),but no correlation with LVMI,CIMT and ba PWV(P>0.05).There was a negative correlation between serum uric acid level and e GFR in male patients with hypertension(P<0.01,?=-0.270),but no correlation with LVMI,CIMT and ba PWV(P<0.05).Serum uric acid level was negatively correlated with e GFR in female patients with hypertension(P<0.01,?=-0.265),but no correlation with LVMI,CIMT and ba PWV(P>0.05).2.After adjusting for age,gender,BMI,smoking,systolic blood pressure,diastolic blood pressure,blood lipids,fasting blood glucose,in all hypertensive patients with hyperuricemia,the hyperuricemia group had a 5.10-fold risk of renal dysfunction than the normal uric acid group;in hypertensive patients with disease course ?1 year and hyperuricemia,the hyperuricemia group had a 6.86-fold risk of renal dysfunction than the normal uric acid group;in the male patients with hypertention and hyperuricemia,the hyperuricemia group had a 10.53-fold risk of renal dysfunction than the normal uric acid group;in hypertensive patients with disease course <1 year and female hypertensive patients with hyperuricemia,there is no statistical difference in the risk of having renal damage between the hyperuricemia group and uric acid normal group(P>0.05).3.After adjustment for age,gender,BMI,smoking,systolic blood pressure,diastolic blood pressure,lipids,and fasting blood glucose,all hypertensive patients with hyperuricemia entailed a 1.7-fold risk of having?2 target organ damages than the normal uric acid group;hypertensive patients with disease course ?1 year and hyperuricemia entailed a 2.71-fold risk of having?2 target organ damages than the normal uric acid group;the male hypertensive patients with hyperuricemia entailed a 2.02-fold risk of having?2 target organ damages than the normal uric acid group;in hypertensive patients with disease course <1 year and female hypertensive patients there is no statistical difference in risk of having?2 target organ damages between the hyperuricemia group and the uric acid-normal group(P>0.05).Conclusion: 1.The level of serum uric acid in all patients with hypertension was negatively correlated with e GFR.The level of serum uric acid was positively correlated with ba PWV in hypertensive patients with disease course ?1 year.The levels of serum uric acid in other patients with hypertension were not correlated with LVMI,CIMT and ba PWV.2.The risk of having renal impairment in hypertensive patients with HUA is related to gender and the duration of hypertension.3.The risk of having multiple target organ damage in hypertensive patients with HUA is related to gender and the duration of hypertension.