Alberto Mazza1, Salvatore Lenti2, Laura Schiavon3, Alvise Del Monte3, Danyelle M Townsend4, Emilio Ramazzina3, Domenico Rubello5, Edoardo Casiglia6. 1. Hypertension Centre, Hospital Santa Maria della Misericordia, Rovigo, Italy. 2. Hypertension Centre, Internal Medicine and Geriatrics, Hospital San Donato, Arezzo, Italy. 3. Department of Internal Medicine, Hospital Santa Maria della Misericordia, Rovigo, Italy. 4. Department of Drug Discovery and Pharmaceutical Sciences, Medical University of South Carolina, USA. 5. Departement of Nuclear Medicine, Hospital Santa Maria della Misericordia, Rovigo, Italy. Electronic address: Domenico.rubello@libero.it. 6. Department of Internal Medicine, University of Padova, Padova, Italy.
Abstract
OBJECTIVE: In clinical practice, patient characteristics predicting resistant hypertension (RH) include higher blood pressure levels, left ventricular hypertrophy, older age, obesity, chronic kidney disease and diabetes. On the contrary little is known about the role of serum uric acid (SUA) as a risk factor for RH in subjects from general population. MATERIAL AND METHODS: 580 elderly subjects aged ≥65 years were enrolled in the Risk Of Vascular complications Impact of Genetics in Old people (ROVIGO) study. RH was defined as the failure to maintain blood pressure values below 140mmHg (systolic) and 90mmHg (diastolic) despite therapeutic interventions that include appropriate lifestyle measures plus adherence to treatment with full doses of at least three antihypertensive drugs, including a diuretic. RH was confirmed using 24-h ambulatory blood pressure measurement. Hyperuricemic was defined as the subjects having SUA ≥6.8mg/dl or taking uricosuric drugs. Gender-specific odds ratio (OR) for RH was calculated by logistic regression analysis. RESULTS: The prevalence of RH was 5.7% in the cohort and was higher in women (8.3%) than in men (3.0%, p<0.05). Independent of chronic kidney disease (OR 3.89, 95% confidence interval 1.49-10.1), hyperuricemia predicted resistant hypertension in women (odds ratio 3.11, 95% confidence intervals 1.06-9.1, p=0.03) but not in men. CONCLUSIONS: In elderly women from the general population, an SUA value of ≥6.8mg/dl triples the risk of RH. SUA assessment should be recommended to better define the pattern of risk associated with RH.
OBJECTIVE: In clinical practice, patient characteristics predicting resistant hypertension (RH) include higher blood pressure levels, left ventricular hypertrophy, older age, obesity, chronic kidney disease and diabetes. On the contrary little is known about the role of serum uric acid (SUA) as a risk factor for RH in subjects from general population. MATERIAL AND METHODS: 580 elderly subjects aged ≥65 years were enrolled in the Risk Of Vascular complications Impact of Genetics in Old people (ROVIGO) study. RH was defined as the failure to maintain blood pressure values below 140mmHg (systolic) and 90mmHg (diastolic) despite therapeutic interventions that include appropriate lifestyle measures plus adherence to treatment with full doses of at least three antihypertensive drugs, including a diuretic. RH was confirmed using 24-h ambulatory blood pressure measurement. Hyperuricemic was defined as the subjects having SUA ≥6.8mg/dl or taking uricosuric drugs. Gender-specific odds ratio (OR) for RH was calculated by logistic regression analysis. RESULTS: The prevalence of RH was 5.7% in the cohort and was higher in women (8.3%) than in men (3.0%, p<0.05). Independent of chronic kidney disease (OR 3.89, 95% confidence interval 1.49-10.1), hyperuricemia predicted resistant hypertension in women (odds ratio 3.11, 95% confidence intervals 1.06-9.1, p=0.03) but not in men. CONCLUSIONS: In elderly women from the general population, an SUA value of ≥6.8mg/dl triples the risk of RH. SUA assessment should be recommended to better define the pattern of risk associated with RH.
Authors: Claudio Borghi; Enrico Agabiti Rosei; Thomas Bardin; Jesse Dawson; Anna Dominiczak; Jan T Kielstein; Athanasios J Manolis; Fernando Perez-Ruiz; Giuseppe Mancia Journal: J Hypertens Date: 2015-09 Impact factor: 4.844
Authors: Patrick Rossignol; Ziad A Massy; Michel Azizi; George Bakris; Eberhard Ritz; Adrian Covic; David Goldsmith; Gunnar H Heine; Kitty J Jager; Mehmet Kanbay; Francesca Mallamaci; Alberto Ortiz; Raymond Vanholder; Andrzej Wiecek; Carmine Zoccali; Gérard Michel London; Bénédicte Stengel; Denis Fouque Journal: Lancet Date: 2015-10-17 Impact factor: 79.321
Authors: Mateusz Winder; Aleksander J Owczarek; Małgorzata Mossakowska; Katarzyna Broczek; Tomasz Grodzicki; Łukasz Wierucki; Jerzy Chudek Journal: Int J Environ Res Public Health Date: 2021-01-06 Impact factor: 3.390
Authors: Caroline L Benn; Pinky Dua; Rachel Gurrell; Peter Loudon; Andrew Pike; R Ian Storer; Ciara Vangjeli Journal: Front Med (Lausanne) Date: 2018-05-31