Plasma uric acid is related to large arterial stiffness but not to other hemodynamic variables: a study in 606 normotensive and never-medicated hypertensive subjects

Humam Hamid, Venla Kurra, Manoj Kumar Choudhary, Heidi Bouquin, Onni Niemelä, Mika A P Kähönen, Jukka T Mustonen, Ilkka H Pörsti, Jenni K Koskela, Humam Hamid, Venla Kurra, Manoj Kumar Choudhary, Heidi Bouquin, Onni Niemelä, Mika A P Kähönen, Jukka T Mustonen, Ilkka H Pörsti, Jenni K Koskela

Abstract

Background: Elevated level of plasma uric acid (PUA) has been associated with cardiovascular disease, but whether uric acid is an independent risk factor or merely a marker remains controversial.

Methods: We investigated in a cross-sectional setting the association of PUA with hemodynamics in 606 normotensive and never-medicated hypertensive subjects (295 men, 311 women, age range 19-73 years) without cardiovascular disease or gout. In all except 15 individuals, PUA was within the normal range. Supine hemodynamics were recorded using whole-body impedance cardiography and radial tonometric pulse wave analysis.

Results: The mean concentrations of PUA in age, sex and body mass index adjusted quartiles were 234, 278, 314, and 373 µmol/l, respectively. The highest PUA quartile presented with higher aortic to popliteal pulse wave velocity (PWV) than the lowest quartile (8.7 vs. 8.2 m/s, p = 0.026) in analyses additionally adjusted for plasma concentrations of C-reactive protein, low density lipoprotein cholesterol, triglycerides, and mean aortic blood pressure. No differences in radial and aortic blood pressure, wave reflections, heart rate, cardiac output, and systemic vascular resistance were observed between the quartiles. In linear regression analysis, PUA was an independent explanatory factor for PWV (β = 0.168, p < 0.001, R2 of the model 0.591), but not for systolic or diastolic blood pressure. When the regression analysis was performed separately for men and women, PUA was an independent predictor of PWV in both sexes.

Conclusions: PUA concentration was independently and directly associated with large arterial stiffness in individuals without cardiovascular disease and PUA levels predominantly within the normal range. Trial registration ClinicalTrials.gov NCT01742702.

Keywords: Arterial stiffness; Hemodynamics; Impedance cardiography; Pulse wave analysis; Uric acid.

Conflict of interest statement

The authors have no potential competing interests associated with this research.

Figures

Fig. 1
Fig. 1
Radial (A) and aortic (B) systolic blood pressure, and radial (C) and aortic (D) diastolic blood pressure in 606 subjects presented in age, body mass index, sex, and plasma C-reactive protein, triglyceride, and LDL cholesterol adjusted quartiles of plasma uric acid concentration; mean ± 95% confidence interval of the mean
Fig. 2
Fig. 2
Aortic pulse pressure (A), forward wave amplitude (B), augmentation index (C), and pulse wave velocity (D) in 606 all subjects, and pulse wave velocity separately in men (E) and women (F), presented in age, body mass index, sex, C-reactive protein, triglyceride, and LDL cholesterol adjusted quartiles of plasma uric acid concentration; mean ± 95% confidence interval of the mean
Fig. 3
Fig. 3
Heart rate (A), stroke volume (B), cardiac output (C), systemic vascular resistance (D) in 606 subjects presented in age, body mass index, sex, C-reactive protein, triglyceride, and LDL cholesterol adjusted quartiles of plasma uric acid concentration; mean ± 95% confidence interval of the mean

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