Influence of hyperuricemia on elastic properties of arteries in patients with arterial hypertension
Background. Increased level of uric acid (UA) is an extremely common state in general population and among cardiologic patients in particular, the presence of which has a very negative effect on the prognosis. However, in our country this problem is not well studied. Materials and methods. 110 patients were examined, including 68 indiciduals with arterial hypertension and 42 — with normal level of blood pressure. The following studies were performed: measurements of height and weight, body mass index, office systolic (SBP) and diastolic blood pressure (DBP), heart rate, ambulatory blood pressure monitoring, non-invasive determination of central SBP and pulse wave velocity in the arteries of elastic and muscular types (PWVe and PWVm), biochemical blood test with definition of UA level, fasting glucose, total cholesterol, triglycerides, high and low density lipoproteins, echocardiography and ultrasound examination of carotid arteries. Statistical analysis of the results was performed using the IBM statistical software SPSS 21. Results. Patients with hypertension and controls were similar in age. The first stage of the analysis was the assessment of the prevalence of hyperuricemia in the examined samples. UA level was increased in 55 % of patients with hypertension. 17 % of persons with normal blood pressure had elevated UA levels. Individuals with hypertension were divided into 2 subgroups: the first one — with elevated levels of uric acid, the second one — with its normal level. In both subgroups, patients were of the same age and, predominantly, with excess body weight or obesity, there were more men in both subgroups. Patients did not differ significantly according to the basic clinical and demographic characteristics. In the subgroup of individuals with hypertension and hyperuricemia, PWVe was significantly higher — by 1.6 m/s (p = 0.044) than in the subgroup of patients with hypertension and normouricemia. But the value of PWVm was equal in both subgroups. There was a significant correlation between UA level and a history of transient ischemic attack or stroke, retinopathy, arrhythmia, as well as with the 24-h SBP and DBP. Also, we found reliable correlations with central arterial pressure (R = 0.293; P = 0.007), ejection duration (R = 0.49; P < 0,001), subendocardial viability ratio (R = 0.47; P < 0.001), augmentation pressure (R = 0.53; P < 0.001) and standardized augmentation index (R = 0.24; P = 0.016), as well as with PWVe (R = 0.47; P < 0.001). Reliable correlation with the level of UA was observed also for a number of echocardiographic and biochemical parameters. Conclusions. Elevated levels of uric acid were found in 55 % of patients with hypertension and in 17 % of middle-aged subjects without elevated blood pressure. In patients with hypertension and hyperuricemia, PWVe was significantly higher than in persons with hypertension and normal uric acid levels. There was an association of UA concentration with rigidity of arteries and central blood pressure and with augmentation index.
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