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Association of serum uric acid levels with cardiovascular and all-cause mortality in hypertensive patients in China: a cohort study
  1. Shu-Xian Zhang1,2,
  2. Yu-Ling Yu2,
  3. Song-Tao Tang3,
  4. Kenneth Lo2,4,5,
  5. Ying-Qing Feng2,
  6. Ji-Yan Chen1,2
  1. 1 Department of Cardiology, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
  2. 2 Department of Cardiology, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China
  3. 3 Department of Cardiology, Community Health Center of Liaobu County, Dongguan, Guangdong, China
  4. 4 Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong, China
  5. 5 Department of Epidemiology, Centre for Global Cardiometabolic Health, Brown University, Providence, Rhode Island, USA
  1. Correspondence to Dr Kenneth Lo, Department of Cardiology, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China; kenneth_lo{at}brown.edu; Professor Ying-Qing Feng; 651792209{at}qq.com; Professor Ji-Yan Chen; gdphospital{at}163.com

Abstract

Purpose The present study aimed to assess the association of elevated serum uric acid (SUA) and hypouricemia with all-cause mortality and cardiovascular mortality in Chinese hypertensive patients.

Methods In the present prospective cohort, 9325 hypertensive patients from Dongguan, China were enrolled from 2014 to 2018 for analysis. Participants were categorised by quintiles of SUA. The HRs and 95% CIs for the association between SUA, all-cause and cardiovascular mortality were evaluated using the multivariate Cox regression model. After adjusting for multiple confounders, restricted cubic spline analysis was conducted to demonstrate the shape of relationship.

Results After a median follow-up of 4.18 years for 9325 participants, there were 409 (4.4%) and 151 (1.6%) reported cases of all-cause and cardiovascular mortality, respectively. By using the third quintile of SUA (6.68 mg/dL to <7.55 mg/dL for men, 5.63 mg/dL to <6.42 mg/dL for women) as reference, the highest quintiles of SUA were associated with an elevated risk of all cause (HR: 1.34, 95% CI 1.00 to 1.80) in the crude model, but the association was not significant after adjusting for multiple comparisons. The association between low SUA and mortality and the dose–response analysis on the non-linearity of SUA–mortality relationship were not statistically significant.

Conclusions Although the association between SUA levels, all-cause and cardiovascular disease mortality did not appear to be significant among Chinese hypertensive patients, the findings might be confounded by their medical conditions. Further studies are needed to verify the optimal SUA levels for hypertensive patients.

  • hypertension
  • epidemiology

Data availability statement

Data are available upon reasonable request. Raw data were generated at the Guangdong Provincial People’s Hospital. Derived data supporting the findings of this study are available from the corresponding author on request.

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Data availability statement

Data are available upon reasonable request. Raw data were generated at the Guangdong Provincial People’s Hospital. Derived data supporting the findings of this study are available from the corresponding author on request.

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Footnotes

  • Contributors Conceptualisation: SXZ, KL, YQF and JYC. Methodology: SXZ, YLY, KL, YQF and JYC. Formal analysis: SXZ and KL. Data curation: SXZ, YLY, STT, KL, YQF and JYC. Writing—original draft preparation: SXZ and KL. Writing—review and editing: SXZ and KL. Supervision: KL, YQF and JYC. All authors drafted the manuscript. KL, YQF and JYC are the guarantors of the paper.

  • Funding This research was supported by Science and Technology Plan Program of Guangzhou (Number 201803040012), The Key Area R&D Program of Guangdong Province (Number 2019B020227005), Guangdong Provincial People's Hospital Clinical Research Fund (Y012018085), The Fundamental and Applied Basic Research Foundation Project of Guangdong Province (2020A1515010738), and The Climbing Plan of Guangdong Provincial People's Hospital (DFJH2020022).

  • Competing interests None declared.

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