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(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

Ji-Guang Wang; Jan A. Staessen; Robert H. Fagard; Willem H. Birkenhäger; Lansheng Gong; Lisheng Liu; for the Systolic Hypertension in China (Syst-China) Trial Collaborative Group¹

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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