Does It Matter for the Progression From Prehypertension to Hypertension?
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See related article, pp 78–86
Uric acid, the end product of purine oxidation, is engendered from nucleotides and adenosine triphosphate metabolism. Unlike most mammals, serum uric acid concentration is relatively high in humans, partly because of mutations in the uricase gene occurred nearly 15 million years ago.1 Although serum uric acid excess is generally considered as a risk factor for gout and renal calculus, the hypothesis that hyperuricemia mediates cardiovascular disease has emerged only since late 19th century.1 In 1879, it was noticed that some hypertensive patients were from gouty families and that uric acid was involved in the development of hypertension.1
Most of subsequent cross-sectional and longitudinal studies demonstrated that serum uric acid was an independent predictor of hypertension. A meta-analysis2 of 18 prospective studies including 55 607 subjects revealed that hyperuricemia predicted incident hypertension, with a 13% higher risk per 1 mg/dL increment in serum uric acid. However, the association might vary according to age and sex, being more significant in younger and female subjects.2 Most recently, Liu et al3 found that the prediction of hyperuricemia was also true for incident prehypertension. In 15 143 subjects with optimal office blood pressure at baseline, subjects with a …