on April 21, 2003
Hypertension. 2003
Published online before print April 21, 2003, doi: 10.1161/01.HYP.0000069700.62727.C5
Published online before print April 21, 2003, doi: 10.1161/01.HYP.0000069700.62727.C5
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Submitted on January 9, 2003
From the Division of Nephrology (R.J.J., D.-H.K., J.K., S.W., M.M.) and Texas Children's Hospital (D.F.), Baylor College of Medicine, Houston, Tex; Merck and Company, Inc (S.K.), West Point, Pa; The Heart Institute of Spokane (K.R.T.), Spokane, Wash; Hospital Universitario and Universidad del Zulia (B.R.-I.), Maracaibo, Venezuela; and Instituto de Cardiologia (J.H.-A.), Mexico City, Mexico. * To whom correspondence should be addressed. E-mail: rjohnson{at}bcm.tmc.edu.
Abstract--Hyperuricemia is associated with hypertension, vascular disease, renal disease, and cardiovascular events. In this report, we review the epidemiologic evidence and potential mechanisms for this association. We also summarize experimental studies that demonstrate that uric acid is not inert but may have both beneficial functions (acting as an antioxidant) as well as detrimental actions (to stimulate vascular smooth muscle cell proliferation and induce endothelial dysfunction). A recently developed experimental model of mild hyperuricemia also provides the first provocative evidence that uric acid may have a pathogenic role in the development of hypertension, vascular disease, and renal disease. Thus, it is time to reevaluate the role of uric acid as a risk factor for cardiovascular disease and hypertension and to design human studies to address this controversy.
Revised on January 30, 2003
Is There a Pathogenetic Role for Uric Acid in Hypertension and Cardiovascular and Renal Disease?
Richard J. Johnson*;
Key words: antioxidants • hypertension, essential • cardiovascular diseases • renin-angiotensin system • vascular diseases • renal disease
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