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J-shaped association between serum uric acid and acute coronary syndrome in patients with essential hypertension
  1. Geng Shen,
  2. Jia-Yi Huang,
  3. Yu-Ling Yu,
  4. Lin Liu,
  5. Chao-Lei Chen,
  6. Bin Zhang,
  7. Yu-Qing Huang,
  8. Ying Qing Feng
  1. Guangdong Provincial People’s Hospital, School of Medicine, South China University of Technology, Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People’s Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
  1. Correspondence to Professor Ying Qing Feng, Department of Cardiology, Guangdong Provincial People’s Hospital, School of Medicine, South China University of Technology, Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People’s Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China; 651792209{at}qq.com

Abstract

Background The prognostic value of serum uric acid (SUA) for incident acute coronary syndrome (ACS) in hypertensive subjects is uncertain. Therefore, the present study examined the association between SUA and incident ACS in a large cohort of Chinese hypertensive adults.

Methods This was a retrospective cohort study, which enrolled 5473 Chinese community-dwelling hypertensive patients from 1 January 2012 to 31 December 2012. Study outcomes were ACS events, and patients were followed until 31 December 2016. Cox regression analyses were conducted to determine adjusted HRs and 95% CIs for baseline SUA tertiles (low, middle and high group) and for men and women separately.

Results A total of 5473 participants were included in the analysis (median follow-up was 4.5 years). Participants were divided into tertiles based on SUA levels. During follow-up, 9 (0.49%), 14 (0.77%) and 25 (1.37%) patients developed ACS in the lowest, middle and highest tertiles, respectively. When compared with the lowest tertile of SUA, the highest tertile of SUA was associated with ACS risk in all subjects and in men and women separately (HR: 2.62, 95% CI 1.14 to 7.01, p=0.0233; 2.15, 95% CI 1.08 to 6.04, p=0.021, and 3.49, 95% CI 1.25 to 7.74, p=0.017, respectively).

Conclusions Higher SUA levels were independently associated with an elevated risk of ACS incidence. The relationship between SUA levels and ACS in hypertensive patients was J-shaped.

  • uric acid
  • acute coronary syndrome
  • hypertension
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Footnotes

  • Correction notice This article has been corrected since it was published Online First. The affiliation formatting has been corrected.

  • Contributors Y-QH, YQF and BZ conceived the project and designed the baseline and follow-up questionnaire. Y-LY, LL and C-LC contributed to collecting and analysing the data. GS and J-YH wrote the manuscript. Y-QH and YQF revised the manuscript. The final manuscript was read and approved by all authors.

  • Funding During the process of data analysis, writing and submission of the article, this work was supported by the Science and Technology Program of Guangzhou (No. 201604020018, No. 201803040012, No. 201604020186, No. 201604020143 and No. 201510010254), the Natural Science Foundation of Guangdong Province (No. 2015A030313660), the Science and Technology Plan Project of Guangdong Province (No. 2014B020212008), the National Key Research and Development Program of China (No. 2017YFC1307603, No. 2016YFC1301305 and No. 2017YFC0909303) and the Key Area R&D Program of Guangdong Province (No. 2019B020227005).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study protocol was approved by the Ethics committee of Guangdong Provincial People’s Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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