on August 4, 2003
Published online before print August 4, 2003, doi: 10.1161/01.HYP.0000085858.66548.59
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on March 14, 2003
From the Department of Pediatrics, Renal Section (D.I.F.), and the Department of Medicine, Renal Section (R.J.J.), Baylor College of Medicine, Houston, Tex. * To whom correspondence should be addressed. E-mail: dfeig{at}bcm.tmc.edu.
Abstract--Experimental animal models suggest that uric acid might have a pathogenic role in the early development of primary hypertension. We hypothesized that serum uric acid is correlated with blood pressure in children with new-onset, untreated, primary hypertension. We evaluated 125 consecutive children referred to the Baylor Pediatric Renal Program for evaluation of hypertension. None of the subjects had previously been evaluated or treated for hypertension. The children ranged in age from 6 to 18 years (mean, 13.4±3.3) and had normal renal function (creatinine clearance >80 mL · min-1 · 1.73 m-2). Sixty-three children had primary hypertension, 40 had secondary hypertension, and 22 had white-coat hypertension. Forty controls with normal blood pressure were recruited from the renal clinic. Uric acid levels were directly correlated with systolic (r=0.80, P=0.0002) and diastolic (r=0.66, P=0.0006) blood pressure in controls and in subjects with primary hypertension and were independent of renal function. Serum uric acid concentrations >5.5 mg/dL were found in 89% of subjects with primary hypertension, in 30% with secondary hypertension, in 0% with white-coat hypertension, and in 0% of controls. We conclude that serum uric acid is directly correlated with blood pressure in untreated children and that a serum uric acid value >5.5 mg/dL in an adolescent being evaluated for hypertension strongly suggests primary hypertension as opposed to white-coat or secondary hypertension. These results are consistent with the hypothesis that uric acid might have a role in the early pathogenesis of primary hypertension.
Revised on April 9, 2003
Hyperuricemia in Childhood Primary Hypertension
Daniel I. Feig* and Richard J. Johnson
Key words: uric acid • hypertension, essential • children • renal disease
This article has been cited by other articles:
 |
|
 |
|
  H. Frank, J. Graf, U. Amann-Gassner, R. Bratke, H. Daniel, U. Heemann, and H. Hauner Effect of short-term high-protein compared with normal-protein diets on renal hemodynamics and associated variables in healthy young men Am. J. Clinical Nutrition, December 1, 2009; 90(6): 1509 - 1516. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Rinat, R. Becker-Cohen, A. Nir, S. Feinstein, D. Shemesh, N. Algur, E. Ben Shalom, B. Farber, and Y. Frishberg A comprehensive study of cardiovascular risk factors, cardiac function and vascular disease in children with chronic renal failure Nephrol. Dial. Transplant., November 23, 2009; (2009) gfp570v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. D. Rule, B. L. Fridley, S. C. Hunt, Y. Asmann, E. Boerwinkle, J. S. Pankow, T. H. Mosley, and S. T. Turner Genome-wide linkage analysis for uric acid in families enriched for hypertension Nephrol. Dial. Transplant., August 1, 2009; 24(8): 2414 - 2420. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Kosugi, T. Nakayama, M. Heinig, L. Zhang, Y. Yuzawa, L. G. Sanchez-Lozada, C. Roncal, R. J. Johnson, and T. Nakagawa Effect of lowering uric acid on renal disease in the type 2 diabetic db/db mice Am J Physiol Renal Physiol, August 1, 2009; 297(2): F481 - F488. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Johnson, S. E. Perez-Pozo, Y. Y. Sautin, J. Manitius, L. G. Sanchez-Lozada, D. I. Feig, M. Shafiu, M. Segal, R. J. Glassock, M. Shimada, et al. Hypothesis: Could Excessive Fructose Intake and Uric Acid Cause Type 2 Diabetes? Endocr. Rev., February 1, 2009; 30(1): 96 - 116. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Pacifico, V. Cantisani, C. Anania, E. Bonaiuto, F. Martino, R. Pascone, and C. Chiesa Serum uric acid and its association with metabolic syndrome and carotid atherosclerosis in obese children Eur. J. Endocrinol., January 1, 2009; 160(1): 45 - 52. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Mohandas and R. J. Johnson Uric Acid Levels Increase Risk for New-Onset Kidney Disease J. Am. Soc. Nephrol., December 1, 2008; 19(12): 2251 - 2253. [Full Text] [PDF]
|
|
|
|
 |
|
 D. I. Feig, D.-H. Kang, and R. J. Johnson Uric Acid and Cardiovascular Risk N. Engl. J. Med., October 23, 2008; 359(17): 1811 - 1821. [Full Text] [PDF]
|
|
|
|
 |
|
 D. I. Feig, B. Soletsky, and R. J. Johnson Effect of Allopurinol on Blood Pressure of Adolescents With Newly Diagnosed Essential Hypertension: A Randomized Trial JAMA, August 27, 2008; 300(8): 924 - 932. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. G. Sanchez-Lozada, E. Tapia, V. Soto, C. Avila-Casado, M. Franco, L. Zhao, and R. J. Johnson Treatment with the xanthine oxidase inhibitor febuxostat lowers uric acid and alleviates systemic and glomerular hypertension in experimental hyperuricaemia Nephrol. Dial. Transplant., April 1, 2008; 23(4): 1179 - 1185. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Ritz Cardiovascular Literature--Beyond Nephrology Clin. J. Am. Soc. Nephrol., March 1, 2008; 3(2): 317 - 323. [Full Text] [PDF]
|
|
|
|
|
|
R. J Johnson, M. S Segal, Y. Sautin, T. Nakagawa, D. I Feig, D.-H. Kang, M. S Gersch, S. Benner, and L. G Sanchez-Lozada Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease Am. J. Clinical Nutrition, October 1, 2007; 86(4): 899 - 906. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Hadtstein and F. Schaefer What adult nephrologists should know about childhood blood pressure Nephrol. Dial. Transplant., August 1, 2007; 22(8): 2119 - 2123. [Full Text] [PDF]
|
|
|
|
 |
|
 L. G. Feld and H. Corey Hypertension in Childhood Pediatr. Rev., August 1, 2007; 28(8): 283 - 298. [Full Text] [PDF]
|
|
|
|
 |
|
 E. S. Ford, C. Li, S. Cook, and H. K. Choi Serum Concentrations of Uric Acid and the Metabolic Syndrome Among US Children and Adolescents Circulation, May 15, 2007; 115(19): 2526 - 2532. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. G. Sanchez-Lozada, E. Tapia, R. Lopez-Molina, T. Nepomuceno, V. Soto, C. Avila-Casado, T. Nakagawa, R. J. Johnson, J. Herrera-Acosta, and M. Franco Effects of acute and chronic L-arginine treatment in experimental hyperuricemia Am J Physiol Renal Physiol, April 1, 2007; 292(4): F1238 - F1244. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Podoll, M. Grenier, B. Croix, and D. I. Feig Inaccuracy in Pediatric Outpatient Blood Pressure Measurement Pediatrics, March 1, 2007; 119(3): e538 - e543. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H J E M Janssens, E H van de Lisdonk, M Janssen, H J M van den Hoogen, and A L M Verbeek Gout, not induced by diuretics? A case-control study from primary care Ann Rheum Dis, August 1, 2006; 65(8): 1080 - 1083. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. L. Price, Y. Y. Sautin, D. A. Long, L. Zhang, H. Miyazaki, W. Mu, H. Endou, and R. J. Johnson Human Vascular Smooth Muscle Cells Express a Urate Transporter J. Am. Soc. Nephrol., July 1, 2006; 17(7): 1791 - 1795. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. C.P. Franco, D. M.J. Christofalo, A. L. Sawaya, S. A. Ajzen, and R. Sesso Effects of Low Birth Weight in 8- to 13-Year-Old Children: Implications in Endothelial Function and Uric Acid Levels Hypertension, July 1, 2006; 48(1): 45 - 50. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. I. Feig, B. Rodriguez-Iturbe, T. Nakagawa, and R. J. Johnson Nephron Number, Uric Acid, and Renal Microvascular Disease in the Pathogenesis of Essential Hypertension Hypertension, July 1, 2006; 48(1): 25 - 26. [Full Text] [PDF]
|
|
|
|
|
|
D. I. Feig, M. Mazzali, D.-H. Kang, T. Nakagawa, K. Price, J. Kannelis, and R. J. Johnson Serum Uric Acid: A Risk Factor and a Target for Treatment? J. Am. Soc. Nephrol., April 1, 2006; 17(4_suppl_2): S69 - S73. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Iwashima, T. Horio, K. Kamide, H. Rakugi, T. Ogihara, and Y. Kawano Uric Acid, Left Ventricular Mass Index, and Risk of Cardiovascular Disease in Essential Hypertension Hypertension, February 1, 2006; 47(2): 195 - 202. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D.-H. Kang, S.-K. Park, I.-K. Lee, and R. J. Johnson Uric Acid-Induced C-Reactive Protein Expression: Implication on Cell Proliferation and Nitric Oxide Production of Human Vascular Cells J. Am. Soc. Nephrol., December 1, 2005; 16(12): 3553 - 3562. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Masuo, T. Katsuya, Y. Fu, H. Rakugi, T. Ogihara, and M. L. Tuck Lys418Asn Polymorphism of the {alpha}2-Adrenoceptor Gene Relates to Serum Uric Acid Levels But Not to Insulin Sensitivity Hypertension, July 1, 2005; 46(1): 144 - 150. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Hediger, R. J Johnson, H. Miyazaki, and H. Endou Molecular Physiology of Urate Transport Physiology, April 1, 2005; 20(2): 125 - 133. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Johnson, D. I. Feig, J. Herrera-Acosta, and D.-H. Kang Resurrection of Uric Acid as a Causal Risk Factor in Essential Hypertension Hypertension, January 1, 2005; 45(1): 18 - 20. [Full Text] [PDF]
|
|
|
|
|
|
J. Sundstrom, L. Sullivan, R. B. D'Agostino, D. Levy, W. B. Kannel, and R. S. Vasan Relations of Serum Uric Acid to Longitudinal Blood Pressure Tracking and Hypertension Incidence Hypertension, January 1, 2005; 45(1): 28 - 33. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. B. Alper Jr, W. Chen, L. Yau, S. R. Srinivasan, G. S. Berenson, and L. L. Hamm Childhood Uric Acid Predicts Adult Blood Pressure: The Bogalusa Heart Study Hypertension, January 1, 2005; 45(1): 34 - 38. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. L. Friedman Serum Uric Acid and Hypertension-Who Knew? AAP Grand Rounds, November 1, 2004; 12(5): 53 - 54. [Full Text] [PDF]
|
|