(Hypertension. 2001;37:1069.)
© 2001 American Heart Association, Inc.
Scientific Contributions |
Prognostic Significance of Serum Creatinine and Uric Acid in Older Chinese Patients With Isolated Systolic Hypertension
From the Hypertension Division (J.-G.W., L.L.), Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China; the Study Coordinating Center (J.-G.W., J.A.S., R.H.F.), Hypertension and Cardiovascular Rehabilitation Unit, Department of Molecular and Cardiovascular Research, University of Leuven, Leuven, Belgium; Erasmus University (W.H.B.), Rotterdam, the Netherlands; and the Shanghai Hypertension Institute (L.G.), Shanghai Second Medical University, Shanghai, People’s Republic of China.
Correspondence to Jan A. Staessen, MD, PhD, Studiecoördinatiecentrum, Laboratorium Hypertensie, Gebouw Onderwijs en Navorsing, Campus Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. E-mail jan.staessen{at}med.kuleuven.ac.be
Abstract—We
examined the relation of serum creatinine and uric acid to
mortality and cardiovascular disease in older (aged
60 years) Chinese patients with isolated systolic
hypertension (systolic/diastolic blood pressure
160/<95 mm Hg). We used Cox regression to correlate outcome
with baseline serum creatinine and uric acid measured in
1880 and 1873, respectively, of the 2394 patients enrolled in the
placebo-controlled Systolic Hypertension in China (Syst-China)
Trial. Median follow-up was 3 years. In multiple Cox regression
analysis with adjustment for gender, age, active treatment, and
other significant covariates, serum creatinine was
significantly associated with a worse prognosis. The relative hazard
rates (95% CIs) associated with a 20-µmol/L increase in serum
creatinine for all-cause, cardiovascular,
and stroke mortality were 1.16 (1.05 to 1.27,
P=0.003), 1.15 (1.01 to 1.31,
P=0.03), and 1.37 (1.13 to
1.65, P=0.001), respectively.
In a similar analysis, which also accounted for serum
creatinine, serum uric acid was also significantly and
independently associated with excess mortality of
cardiovascular disease and stroke. The relative hazard
rates associated with a 50-µmol/L increase of serum uric acid were
1.14 (1.02 to 1.27, P=0.02) for
cardiovascular mortality and 1.34 (1.14 to 1.57,
P<0.001) for fatal stroke. In
conclusion, in older Chinese patients with isolated systolic
hypertension, serum creatinine and serum uric acid were
predictors of
mortality.
Key Words: uric acid • creatinine • mortality • cardiovascular diseases • stroke • elderly
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