Association of hypertension and hypertriglyceridemia on incident hyperuricemia: an 8-year prospective cohort study

Abstract

Background: Hypertension and high triglyceride are two of the most important risk factors for hyperuricemia. Epidemiological records show that hypertension and dyslipidemia often coexist and may significantly increase the risk of target organ damage. However, their combined effect on incident hyperuricemia is poorly understood. Thus, we aimed to investigate the separate and combined effect of hypertension and hypertriglyceridemia on the incidence of hyperuricemia.

Methods: A prospective cohort study of 6424 hyperuricemia-free participants aged 20 to 94 years between August 2009 and October 2017 was performed at Tianjin General Hospital of China. Participants were categorized into four groups by combining hypertension and hypertriglyceridemia status at baseline. The restricted cubic spline fitting Cox regression model was used to evaluate the relationship between blood pressure and triglyceride and hyperuricemia. Cox regression models were performed to calculate hazard ratios (HRs) and 95% confident intervals (CIs) to estimate baseline factors and their association with the incidence of hyperuricemia. A Kaplan-Meier survival analysis was performed to compare the incidence of hyperuricemia among subjects in each separate and combined hypertension and hypertriglyceridemia group.

Results: During the 8-year follow-up period, 1259 subjects developed hyperuricemia (20.6%). There existed positive relationships between blood pressure and triglyceride levels and hyperuricemia. This risk factor arising from a combination of the two (HR, 3.02; 95% CI 2.60-3.50) is greater than that from hypertension (HR, 1.48; 95% CI 1.28-1.71) or hypertriglyceridemia (HR, 1.84; 95% CI 1.55-2.18) separately. The Kaplan-Meier survival analysis indicated that combined effect of hypertension and hypertriglyceridemia may predict higher onset of hyperuricemia.

Conclusion: The combined effect of hypertension and hypertriglyceridemia on the risk of hyperuricemia is much stronger than that by hypertension or hypertriglyceridemia separately. Hypertension combined with hypertriglyceridemia may be an independent and powerful predictor for hyperuricemia.

Keywords: Hypertension; Hypertriglyceridemia; Hyperuricemia; Prospective cohort study.

Fig. 1

Kaplan‑Meier curves for the incidence of hyperuricemia among four groups in overall (a); in men (b), and in women (c). (log‑rank test P-value < 0.05, HTN + HTG group vs. other groups). Normal, normotension and normal triglyceride; HTN, hypertension and normal triglyceride; HTG: normotension and hypertriglyceridemia; HTN + HTG, hypertension and hypertriglyceridemia

Fig. 2

Receiver operating characteristic (ROC) curve for the prediction of hyperuricemia from blood pressure combined with TG levels in overall (a); in men (b), and in women (c). AUC, area under the curve. All models AUC > 0.500, P < 0.001