Prevalence of Hyperuricemia and Its Association with Cardiovascular Risk Factors and Subclinical Target Organ Damage

The role of uric acid levels in the cardiovascular continuum is not clear. Our objective is to analyze the prevalence of hyperuricemia (HU) and its association with cardiovascular risk factors (CVRF), subclinical target organ damage (sTOD), and cardiovascular diseases (CVD). We evaluated the prevalence of HU in 6.927 patients included in the baseline visit of the IBERICAN study. HU was defined as uric acid levels above 6 mg/dL in women, and 7 mg/dL in men. Using adjusted logistic regression models, the odds ratios were estimated according to CVRF, sTOD, and CVD. The prevalence of HU was 16.3%. The risk of HU was higher in patients with pathological glomerular filtration rate (aOR: 2.92), heart failure (HF) (aOR: 1.91), abdominal obesity (aOR: 1.80), hypertension (HTN) (aOR: 1.65), use of thiazides (aOR: 1.54), left ventricular hypertrophy (LVH) (aOR: 1.36), atrial fibrillation (AFIB) (aOR: 1.29), and albuminuria (aOR: 1.27). On the other hand, being female (aOR: 0.82) showed a reduced risk. The prevalence of HU was higher in men, in patients presenting CVRF such as HTN and abdominal obesity, and with co-existence of LVH, atrial fibrillation (AFIB), HF, and any form of kidney injury. These associations raise the possibility that HU forms part of the early stages of the cardiovascular continuum. This may influence its management in Primary Healthcare because the presence of HU could mean an increased CV risk in the patients

El papel de la hiperuricemia como factor de riesgo cardiovascular en los pacientes del estudio IBERICAN

En esta tesis se analiza el valor pronóstico neto que se asocia a la hiperuricemia en términos de eventos y mortalidad cardiovasculares en los pacientes incluidos en el estudio IBERICAN, estudio longitudinal cuyo objetivo general es conocer la prevalencia, incidencia y distribución geográfica de los factores de riesgo cardiovascular y de las enfermedades cardiovasculares en población adulta española asistida en atención primaria. Además se analiza la prevalencia de los factores de riesgo cardiovascular, lesión de órgano diana mediada por hipertensión y enfermedad cardiovascular en los pacientes con hiperuricemia comparados con los pacientes sin hiperuricemia. Finalmente, también se analiza si valores de ácido úrico considerados normales actualmente pueden implicar un riesgo progresivamente mayor de eventos cardiovasculares. Tras analizar los resultados podemos concluir que la hiperuricemia asocia mayor riesgo pronóstico de desarrollar eventos cardiovasculares; que niveles intermedios de uricemia, especialmente en mujeres pueden ser indicativos de mayor riesgo de eventos cardiovasculares; que los pacientes con hiperuricemia tienen mayor prevalencia de todos los factores de riesgo cardiovascular (a excepción del tabaco); que la lesión de órgano diana mediada por hipertensión fue más frecuente en pacientes con hiperuricemia (presión de pulso > 60 en mayores de 65 años, hipertrofia ventricular izquierda y albuminuria) y que las enfermedades cardiovasculares fueron más prevalentes en los pacientes con hiperuricemia (fibrilación auricular e insuficiencia cardiaca)

Prevalence of Hyperuricemia and Its Association with Cardiovascular Risk Factors and Subclinical Target Organ Damage

The role of uric acid levels in the cardiovascular continuum is not clear. Our objective is to analyze the prevalence of hyperuricemia (HU) and its association with cardiovascular risk factors (CVRF), subclinical target organ damage (sTOD), and cardiovascular diseases (CVD). We evaluated the prevalence of HU in 6.927 patients included in the baseline visit of the IBERICAN study. HU was defined as uric acid levels above 6 mg/dL in women, and 7 mg/dL in men. Using adjusted logistic regression models, the odds ratios were estimated according to CVRF, sTOD, and CVD. The prevalence of HU was 16.3%. The risk of HU was higher in patients with pathological glomerular filtration rate (aOR: 2.92), heart failure (HF) (aOR: 1.91), abdominal obesity (aOR: 1.80), hypertension (HTN) (aOR: 1.65), use of thiazides (aOR: 1.54), left ventricular hypertrophy (LVH) (aOR: 1.36), atrial fibrillation (AFIB) (aOR: 1.29), and albuminuria (aOR: 1.27). On the other hand, being female (aOR: 0.82) showed a reduced risk. The prevalence of HU was higher in men, in patients presenting CVRF such as HTN and abdominal obesity, and with co-existence of LVH, atrial fibrillation (AFIB), HF, and any form of kidney injury. These associations raise the possibility that HU forms part of the early stages of the cardiovascular continuum. This may influence its management in Primary Healthcare because the presence of HU could mean an increased CV risk in the patients