Relationship between Uric Acid and All-Cause and Cardiovascular Mortality in Individuals with Hypertension

Abstract

Hypertension is a common disease in the general population. Serum uric acid (SUA) levels have been linked to the occurrence and worsening of hypertension. However, it is unclear whether SUA has an impact on all-cause mortality (ACM) and cardiovascular mortality (CVM) in hypertensive individuals. This research aimed to assess the relation between SUA and mortality in a hypertensive population using data from the National Health and Nutrition Examination Survey (NHANES) database.The research comprised 13,363 hypertensive patients from NHANES during 2001-2018. A weighted Cox proportional risk model and restricted cubic spline (RCS) were used for the analysis.During the follow-up period among the 13,363 participants, there were 3,066 deaths from all causes, of which 846 were from CVD. After adjusting for variables, HRs and corresponding 95% CIs were calculated for different SUA categories (Q1: SUA < 285.5 μmol/L, Q2: 285.5 μmol/L ≤ SUA < 339.0 μmol/L, Q3: 339.0 μmol/L ≤ SUA < 404.5 μmol/L, Q4: SUA ≥ 404.5 μmol/L). The ACM was 1 (reference), 1.557 (1.387, 1.747), 1.312 (1.154, 1.492), and 1.393 (1.228, 1.580) (all P < 0.01); while the CVM was 1 (reference), 1.308 (1.043, 1.641) (P = 0.041), 1.182 (0.938, 1.490) (P = 0.261), and 1.151 (0.904, 1.464) (P = 0.410). The RCS showed that both high and low levels of SUA were related to an elevated risk of ACM and CVM in a population of hypertensive individuals.In hypertensive individuals, an elevated risk of both ACM and CVM is associated with high and low levels of SUA.

Keywords: Hyperuricemia; Hypouricemia; Nonlinear relation.