Alessandro Maloberti1,2, Michele Bombelli2,3, Rita Facchetti2, Carlo Maria Barbagallo4, Bruno Bernardino5, Enrico Agabiti Rosei6, Edoardo Casiglia7, Arrigo Francesco Giuseppe Cicero8, Massimo Cirillo9, Pietro Cirillo10, Giovambattista Desideri5, Lanfranco D'elia11, Raffaella Dell'Oro2,3, Claudio Ferri5, Ferruccio Galletti11, Cristina Giannattasio1,2, Gesualdo Loreto10, Guido Iaccarino12, Luciano Lippa13, Francesca Mallamaci14, Stefano Masi15, Alberto Mazza16, Maria Lorenza Muiesan6, Pietro Nazzaro17, Gianfranco Parati2,18, Paolo Palatini7, Paolo Pauletto19, Roberto Pontremoli20, Fosca Quarti-Trevano2,3, Marcello Rattazzi19,21, Giulia Rivasi22, Massimo Salvetti6, Valerie Tikhonoff21, Giuliano Tocci23,24, Andrea Ungar22, Paolo Verdecchia25, Francesca Viazzi20, Massimo Volpe23,24, Agostino Virdis15, Guido Grassi2, Claudio Borghi8. 1. Cardiology IV, 'A. De Gasperis' Department, Ospedale Niguarda Ca' Granda. 2. School of Medicine and Surgery, Milano-Bicocca University, Milan. 3. Clinica Medica, San Gerardo Hospital, Monza. 4. Biomedical Department of Internal Medicine and Specialistics, University of Palermo, Palermo. 5. Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila. 6. Department of Clinical and Experimental Sciences, University of Brescia, Brescia. 7. Studium Patavinum, Department of Medicine, University of Padua, Padua. 8. Department of Medical and Surgical Science, Alma Mater Studiorum University of Bologna, Bologna. 9. Department of Clinical Medicine and Surgery, "Federico II" University of Naples Medical School, Naples. 10. Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, 'Aldo Moro' University of Bari, Bari. 11. Department of Public Health, 'Federico II' University of Naples. 12. Department of Advanced Biomedical Sciences, 'Federico II' University of Naples, Naples. 13. Italian Society of General Medicine (SIMG), Avezzano, L'Aquila. 14. CNR-IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit, Reggio Calabria. 15. Department of Clinical and Experimental Medicine, University of Pisa, Pisa. 16. Department of Internal Medicine, Santa Maria della Misericordia General Hospital, AULSS 5 Polesana, Rovigo. 17. Department of Medical Basic Sciences, Neurosciences and Sense Organs, University of Bari Medical School, Bari. 18. Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan. 19. Medicina Interna I, Ca' Foncello University Hospital, Treviso. 20. Department of Internal Medicine, University of Genoa and Policlinico SanMartino, Genoa. 21. Department of Medicine, University of Padua, Padua. 22. Department of Geriatric and Intensive Care Medicine, Careggi Hospital and University of Florence, Florence. 23. Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome. 24. IRCCS Neuromed, Pozzilli. 25. Hospital S. Maria della Misericordia, Perugia, Italy.
Abstract
OBJECTIVE: Although the relationship between hyperuricemia and cardiovascular events has been extensively examined, data on the role of diuretic-related hyperuricemia are still scanty. The present study was designed to collect information on the relationship between diuretic-related hyperuricemia and cardiovascular events. METHODS: The URic acid Right for heArt Health (URRAH) study is a nationwide, multicentre, observational cohort study involving data on individuals recruited from all the Italy territory under the patronage of the Italian Society of Hypertension with an average follow-up period of 122.3 ± 66.9 months. Patients were classified into four groups according to the diuretic use (yes vs. no) and serum uric acid (SUA) levels (higher vs. lower than the median value of 4.8 mg/dl). All-cause death, cardiovascular deaths and first cardiovascular event were considered as outcomes. RESULTS: Seventeen thousand, seven hundred and forty-seven individuals were included in the analysis. Mean age was 57.1 ± 15.2 years, men were 45.3% and SBP and DBP amounted to 144.1 ± 24.6 and 85.2 ± 13.2 mmHg. 17.2% of individuals take diuretics of whom 58% had SUA higher than median value. Patients with hyperuricemia without diuretic use served as reference group. In multivariate adjusted analysis (sex, age, SBP, BMI, glucose, total cholesterol, and glomerular filtration rate) individuals with hyperuricemia and diuretic use exhibit a similar risk for the three outcomes as compared with the reference group. CONCLUSION: Our study showed that diuretic-related hyperuricemia carry a similar risk of cardiovascular events and all-cause mortality when compared with individuals that present hyperuricemia in absence of diuretic therapy.
OBJECTIVE: Although the relationship between hyperuricemia and cardiovascular events has been extensively examined, data on the role of diuretic-related hyperuricemia are still scanty. The present study was designed to collect information on the relationship between diuretic-related hyperuricemia and cardiovascular events. METHODS: The URic acid Right for heArt Health (URRAH) study is a nationwide, multicentre, observational cohort study involving data on individuals recruited from all the Italy territory under the patronage of the Italian Society of Hypertension with an average follow-up period of 122.3 ± 66.9 months. Patients were classified into four groups according to the diuretic use (yes vs. no) and serum uric acid (SUA) levels (higher vs. lower than the median value of 4.8 mg/dl). All-cause death, cardiovascular deaths and first cardiovascular event were considered as outcomes. RESULTS: Seventeen thousand, seven hundred and forty-seven individuals were included in the analysis. Mean age was 57.1 ± 15.2 years, men were 45.3% and SBP and DBP amounted to 144.1 ± 24.6 and 85.2 ± 13.2 mmHg. 17.2% of individuals take diuretics of whom 58% had SUA higher than median value. Patients with hyperuricemia without diuretic use served as reference group. In multivariate adjusted analysis (sex, age, SBP, BMI, glucose, total cholesterol, and glomerular filtration rate) individuals with hyperuricemia and diuretic use exhibit a similar risk for the three outcomes as compared with the reference group. CONCLUSION: Our study showed that diuretic-related hyperuricemia carry a similar risk of cardiovascular events and all-cause mortality when compared with individuals that present hyperuricemia in absence of diuretic therapy.
Authors: Min Tao; Xiaoyan Ma; Xiaoling Pi; Yingfeng Shi; Lunxian Tang; Yan Hu; Hui Chen; Xun Zhou; Lin Du; Yongbin Chi; Shougang Zhuang; Na Liu Journal: BMJ Open Date: 2021-09-16 Impact factor: 3.006
Authors: Ruining Li; Lin Zeng; Chengkai Wu; Pengcheng Ma; Hao Cui; Liya Chen; Qimei Li; Chang Hong; Li Liu; Lushan Xiao; Wenyuan Li Journal: Int J Gen Med Date: 2022-03-10