Study of epidemiological aspects of hyperuricemia in Poland

Abstract

Background: The results of the latest epidemiological studies show that the problem of hyperuricemia affects many millions of people. The main purpose of the study was to assess the knowledge of physicians with regard to the epidemiology and treatment of hyperuricemia in Poland.

Methods: CAPI (computer assisted personal interview) interviews were conducted using short questionnaires among primary health care physicians, cardiologists and diabetologists. The entire questionnaire included 11 questions. Questions were asked to physicians at 5 different periods in time. The number of physicians surveyed, depended on the time period, and ranged from 8663 to 9980.

Results: Only every 1 in 7 physicians (14%) considered that hyperuricemia in patients with cardiovascular risk factors begins when the uric acid level is 5 mg/dL, thus in line with the expert recommendations. 72% of respondents asked to indicate the uric acid levels they consider to be indicative of hyperuricemia in patients in the cardiovascular risk group, gave values ranging from 6 to 7 mg/dL, namely the values justified in cases of a patient without such a risk, i.e. in the general population. 86% of doctors surveyed gave values different from that recommended by experts.

Conclusions: The findings of the questionnaire in this survey suggests that doctors often underestimate the problem of hyperuricemia in patients with a high risk of cardiovascular disease. An important step towards more effective therapy of hyperuricemia in routine clinical practice is to raise the awareness of hyperuricemia and its comorbidities both among doctors and patients and encourage monitoring and treatment.

Keywords: arterial hypertension; hyperuricemia.

Figure 1

Uric acid reference concentration value considered by physicians as hyperuricaemia at the patients of cardiovascular risk group — distribution of all the responses.

Figure 2

Diseases usually accompanied by hyperuricaemia — distribution of responses.

Figure 3

Average age of patients with hyperuricaemia > 5 mg/dL (298 μmol/L) of the cardiovascular risk group — distribution of responses and average.

Figure 4

Frequency of ordering urea acid tests in serum at patients with hyperuricaemia > 5 mg/dL (298 μmol/L) of the cardiovascular risk group — distribution of responses.

Figure 5

Average concentration of uric acid at patients with hyperuricemia > 5 mg/dL (298 μmol/L) of the cardiovascular risk group — distribution of responses and average.

Figure 6

Uric acid concentration value at which the physician includes pharmacologic treatment of hyperuricemia for patients of the cardiovascular risk group — aggregated distribution of responses and average.

Figure 7

Percentage of patients with hyperuricemia > 5 mg/dL (298 μmol/L) in the cardiovascular risk group taking medicines lowering uric acid concentration, whose doctor had increased the dose in the prior 3–4 months — aggregated distribution of responses and the average.

Figure 8

The assumed length of pharmacological treatment of hyperuricemia for patients in the cardiovascular risk group (> 5 mg/dL; 298 μmol/l) — distribution of responses.

Figure 9

Assessment of the impact of hyperuricemia (> 5 mg/dL, 298 μmol/L) on cardiovascular risk — distribution of responses.

Figure 10

Frequency of hyperuricemia for patients in the cardiovascular risk group (> 5 mg/dL; 298 μmol/L) within the prior 2 years — distribution of responses.

Figure 11

Management strategy for patients suffering from hyperuricemia [9]; CV — cardiovascular; CKD — chronic kidney disease; MI — myocardial infarction; SUA — serum uric acid.