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(Hypertension. 2006;47:195.)
© 2006 American Heart Association, Inc.

Original Articles

Uric Acid, Left Ventricular Mass Index, and Risk of Cardiovascular Disease in Essential Hypertension

Yoshio Iwashima; Takeshi Horio; Kei Kamide; Hiromi Rakugi; Toshio Ogihara; Yuhei Kawano

From the Department of Geriatric Medicine (Y.I., H.R., T.O.), Graduate School of Medicine, Osaka University, and Division of Hypertension and Nephrology (T.H., K.K., Y.K.), Department of Medicine, National Cardiovascular Center, Osaka, Japan.

Correspondence to Takeshi Horio, Division of Hypertension and Nephrology, Department of Medicine, National Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka 565-8565, Japan. E-mail thorio{at}ri.ncvc.go.jp

Elevated serum uric acid (UA) is frequently encountered in individuals with hypertension, but whether the relationship between UA and cardiovascular events is circumstantial or causal remains to be answered. We examined the association between serum UA and left ventricular mass index (LVMI) and investigated prospectively whether the combination of UA and LVMI can predict the incidence of cardiovascular disease (CVD) in asymptomatic subjects with essential hypertension. A total of 619 subjects (mean age, 61 years; 52% female) free of prior CVD were included in this study. A significant association between UA and LVMI was also confirmed in multiple regression analysis (male: F=4.29, P<0.04; female: F=4.24, P<0.05). During follow-up (mean, 34 months), 28 subjects (14 female) developed CVD including myocardial infarction, angina pectoris, congestive heart failure, cerebral infarction, and transient cerebral ischemia. Sex-specific median values were used to separate the higher group from the lower group of UA and LVMI. Kaplan–Meier curves showed a significantly poorer survival rate in the group with higher UA and LVMI (LVMI, male: >126.9, female: >112.0 g/m²; UA, male: >374.7, female: >303.3 µmol/L; log-rank ²=13.18; P<0.01). Multivariate Cox regression analysis showed that the combination of higher UA and LVMI was an independent predictor for CVD events (hazard ratio, 2.38; P<0.03). Our findings demonstrate that UA is independently associated with LVMI and suggest that the combination of hyperuricemia combined with left ventricular hypertrophy is an independent and powerful predictor for CVD. The association between UA and CVD events may be introduced in part because of a direct association of UA with LVMI.

Key Words: uric acid • cardiovascular diseases • hypertrophy • risk factors

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