Gloria Brombo1, Francesco Bonetti2, Stefano Volpato2, Mario L Morieri2, Ettore Napoli2, Stefania Bandinelli3, Antonio Cherubini4, Marcello Maggio5, Jack Guralnik6, Luigi Ferrucci7, Giovanni Zuliani8. 1. Department of Medical Sciences, Section of Internal and Cardiorespiratory Medicine, University of Ferrara, Italy. Electronic address: g.brombo@gmail.com. 2. Department of Medical Sciences, Section of Internal and Cardiorespiratory Medicine, University of Ferrara, Italy. 3. Geriatric Rehabilitation Unit, Tuscany Regional Health Agency, Florence, Italy. 4. Geriatrics, IRCCS-INRCA, Ancona, Italy. 5. Department of Clinical and Experimental Medicine, Section of Geriatrics, University of Parma, Italy. 6. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA. 7. Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, NIH, Baltimore, USA. 8. Department of Morphology, Surgery and Experimental Medicine, Section of Internal and Cardiorespiratory Medicine, University of Ferrara, Ferrara, Italy.
Abstract
BACKGROUND AND AIMS: Increased uric acid levels correlate with cardiovascular disease and cardiovascular/overall mortality. To identify a uric acid threshold above which cardiovascular mortality rises, we studied the relationship between uric acid concentration and overall/cardiovascular mortality. METHODS AND RESULTS: We analyzed data from the InCHIANTI study, a cohort study of Italian community-dwelling people with 9 years of follow-up. We selected a sample of 947 individuals over 64 years of age, free from cardio-cerebrovascular disease and with available uric acid measurement at baseline. The sample was divided according to plasma uric acid tertiles. The Hazard ratio (HR) for mortality was calculated by multivariate Cox proportional hazard model. Mean age of participants was 75.3 ± 7.3 years; the mean value of uric acid was 5.1 ± 1.4 mg/dl. Over 9-years of follow-up, 342 (36.1%) participants died, 143 deaths (15.1%) were due to cardiovascular disease. Subjects with higher uric acid concentrations presented a higher cardiovascular mortality [II (4.6-5.5 mg/dl) vs I (1.8-4.5 mg/dl) tertile HR: 1.98, 95%C.I. 1.22-3.23; III (≥5.6 mg/dl) vs I tertile HR: 1.87, 95%C.I. 1.13-3.09]. We found a non-linear association between uric acid concentrations and cardiovascular mortality with the lowest mortality for values of about 4.1 mg/dl and a significant risk increment for values above 4.3 mg/dl. CONCLUSION: In community-dwelling older individuals free from cardio-cerebrovascular events, the lowest 9-year cardiovascular mortality was observed for uric acid values far below current target values. If confirmed, these data might represent the background for investigating the efficacy of uric acid levels reduction in similar populations.
BACKGROUND AND AIMS: Increased uric acid levels correlate with cardiovascular disease and cardiovascular/overall mortality. To identify a uric acid threshold above which cardiovascular mortality rises, we studied the relationship between uric acid concentration and overall/cardiovascular mortality. METHODS AND RESULTS: We analyzed data from the InCHIANTI study, a cohort study of Italian community-dwelling people with 9 years of follow-up. We selected a sample of 947 individuals over 64 years of age, free from cardio-cerebrovascular disease and with available uric acid measurement at baseline. The sample was divided according to plasma uric acid tertiles. The Hazard ratio (HR) for mortality was calculated by multivariate Cox proportional hazard model. Mean age of participants was 75.3 ± 7.3 years; the mean value of uric acid was 5.1 ± 1.4 mg/dl. Over 9-years of follow-up, 342 (36.1%) participantsdied, 143 deaths (15.1%) were due to cardiovascular disease. Subjects with higher uric acid concentrations presented a higher cardiovascular mortality [II (4.6-5.5 mg/dl) vs I (1.8-4.5 mg/dl) tertile HR: 1.98, 95%C.I. 1.22-3.23; III (≥5.6 mg/dl) vs I tertile HR: 1.87, 95%C.I. 1.13-3.09]. We found a non-linear association between uric acid concentrations and cardiovascular mortality with the lowest mortality for values of about 4.1 mg/dl and a significant risk increment for values above 4.3 mg/dl. CONCLUSION: In community-dwelling older individuals free from cardio-cerebrovascular events, the lowest 9-year cardiovascular mortality was observed for uric acid values far below current target values. If confirmed, these data might represent the background for investigating the efficacy of uric acid levels reduction in similar populations.
Authors: Michiel J Bos; Peter J Koudstaal; Albert Hofman; Jacqueline C M Witteman; Monique M B Breteler Journal: Stroke Date: 2006-05-04 Impact factor: 7.914
Authors: L Ferrucci; S Bandinelli; E Benvenuti; A Di Iorio; C Macchi; T B Harris; J M Guralnik Journal: J Am Geriatr Soc Date: 2000-12 Impact factor: 5.562
Authors: A G Stack; A Hanley; L F Casserly; C J Cronin; A A Abdalla; T J Kiernan; B V R Murthy; A Hegarty; A Hannigan; H T Nguyen Journal: QJM Date: 2013-04-05