engleski

Serum uric acid is apart to the metabolic syndrome ralated to the seru aldosterone concentration in essential hypertension

The question whether serum uric acid (SUA) is independent cardiovascular (CV) risk factor is still unanswered. Our aim was to analyse association between SUA and blood pressure (BP) values as well as relation between SUA and other CV risk factors in the early phase of essential hypertension (EH). We included 184 persons (91 M / 93 F aged 18 to 78 years): 109 with uncomplicated mild EH and normal renal function (54 M/ 55 F aged 18 to 78 years) who were not treated with drugs that could affect SUA and 75 normotensive subjects (NT) (37 M / 38 F aged 24 to 78 years). According to the SUA level, persons were divided into the three groups (men A 142-283 ; B 285-333 ; C 335-541 ; women A 105-186 ; B 188-242 ; C 246-430). BP was measured using mercury sphygmomanometer (RR) and ambulatory BP monitor (ABPM) (Spacelabs 90207). Patients were on normal diet. SUA, blood glucose (BG), cholesterol (Ch), triglycerides (T), creatinine (C), homocysteine (Ho), lipoprotein a (lpa), fibrinogen (F), plasma renin activity (PRA), serum aldosterone (SA) and daily sodium excretion (SE) were determined. There were no differences in age between SUA groups (p>0.05). We obtained significant differences between the C and the A group in BMI (29.43.9 vs.27.03, 5 ; p=0.017), Ch (6.21.3 vs.5.41.2 ; p=0.01), T (2.41.7 vs.1.20.7 ; p=0.0009) and Ho (9.64.1 vs.6.51.5 ; p=0.026). There were no differences in BP values and values of BG, C, lpa, F (p>0.05). We also failed to find any significant difference in PRA and SE between SUA groups (p>0.05), but SA was the highest in the group C (466171vs.24487 ; p=0.039). Statistically significant (p<0.05) correlation between SUA and hematocrite (r=0.44), C (r=0.51) and Ho (r=0.53) were found. In untreated patients with EH and NT correlation was even more emphasized and present between SUA and Ch (r=0.41), T(r=0.41) and SA (r=0.85). We did not observe significant correlation between SUA and BP values using either RR or ABPM (p>0.05). We failed to found relation between SUA and BP values in early phase of EH as well as in NT. Even in uncomplicated phase of EH persons with the highest SUA values had characteristics of the metabolic syndrome (the highest BMI, Ch, T, Ho), and significant correlation between SUA and these factors were found. It could be concluded that SUA does not increase CV risk influencing BP but it is probably a marker of metabolic disturbance. Significant correlation between SUA and SA is very interesting but further investigation are needed to answer whether there is cause-effect relationship.

hypertension; blood pressure; renin-angiotensin system; hormones

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