Gender Differences in the J-Shaped Association between
Serum Uric Acid Levels and the Incidence of Hypertension
Sangsuwan T, MD¹, Inchaiya P, MD¹, Jamulitrat S, MD¹, Kemapanmanus A¹*, Petcharat P¹*, Sukboonthong P¹*
Affiliation : ¹ Department of Community Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand * Medical Student
Background: Reports regarding the risk of hypertension (HT) in hyperuricemic persons were widely varied due to difference
in definition, gender, and genetic of studied population. The authors then conducted a study to elucidate this risk in a group of
Thai people stratified by serum uric acid (SUA) concentration and gender.
Objective: To evaluate the effect of SUA on the future 8-year risk of developing HT.
Materials and Methods: The persons aged at least 15 years old without HT who visited for physical checkup to Primary Care Unit, General Practice Clinic, General Heath Examination Clinic, and Private General Practice Clinic of Songklanagarind Hospital between March and April 2008 were included in the present study. Medical records were reviewed until end of the study in March 2016 or until HT was diagnosed and treated. SUA concentration was categorized in to eight categories starting from less than 2.9 to more than 8.8 mg%. The incidences of HT were calculated and reported in term of person-time incidence. The association between SUA and HT was analyzed and reported in terms of incidence rate ratio (IRR) using multivariate Poisson regression model.
Results: After a median 6.8-year follow-up (interquartile range 3.7, 7.4), the study identified 309 and 195 incident cases of HT among 1,873 women and 1,019 men respectively. The person-time incidences both in men and women shown J-shaped relation with SUA concentration with inflection points at 4.9 to 5.8 mg% and 2.9 to 3.8 mg%, respectively. Multivariate Poisson regression analysis showed the similar relationship pattern of association between SUA and HT both in men and women.
Conclusion: The results of the present study provide evidence that SUA has the different 8-year risk of developing HT at both high and low concentration. This effect was also different between gender.
Keywords : Longitudinal study, Uric acid, Hyperuricemia, Essential hypertension
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