Is there an association of uric acid level with preclinical target organ damage in moderate-and high-risk hypertensive patients?

Abstract


Aim. To assess an association of uric acid level with preclinical target organ damage in patients with hypertensive disease (HD). Subjects and methods. The trial enrolled 100 patients (63 men and 37 women) with Stage I-II HD at moderate and high risk for cardiovascular events (CVEs). The mean age of the patients was 44.9±1.3 years. Their medical history showed that the duration of hypertension averaged 4.4±0.3 years. The average daily level of systolic blood pressure (BP) was 138.1±1.4 mm Hg and that of diastolic BP was 84.3±1.1 mm Hg. Results. The entire patient group showed a positive correlation between C-reactive protein (CRP) and serum uric acid (SUA) (r = 0.27; p < 0.01), suggesting that the nonspecific inflammatory processes were associated with uric acid levels in patients with HD. An intragroup analysis also revealed a relationship between CRP and SUA levels in the hypertensive patients at high risk for CVEs (r = 0.43; p = 0.01); this relationship was not found in those at their low risk. The hypertensive patients were ascertained to have elevated CRP levels and microalbuminuria, hyperuricosuria, and glomerular hyperfiltration when they had a SUA level >319 µmol/l. Conclusion. It can be assumed that the SUA level >319 µmol/l triggers the activation of nonspecific inflammatory processes, which in turn affects renal microvessels.

Full Text

Есть ли связь уровня мочевой кислоты с доклиническим поражением органов-мишеней у больных гипертонической болезнью среднего и высокого риска?. - Резюме. Цель исследования. Оценить связь уровня мочевой кислоты с доклиническим поражением органов-мишеней у больных гипертонической болезнью (ГБ). Материалы и методы. В исследование включили 100 больных ГБ I-II стадии (63 мужчин и 37 женщин), среднего и высокого риска развития сердечно-сосудистых осложнений (ССО). Средний возраст больных составил 44,9±1,3 года. Длительность течения ГБ по данным анамнеза достигала в среднем 4,4±0,3 года. Среднесуточный уровень систолического артериального давления составил 138,1±1,4 мм рт.ст., диастолического - 84,3±1,1 мм рт.ст. Результаты. В целом по группе больных выявлена позитивная взаимосвязь уровня С-реактивного белка (СРБ) с мочевой кислотой в сыворотке крови - МКСК (r=0,27; p<0,01), что свидетельствует о сопряженности процессов неспецифического воспаления с уровнем мочевой кислоты у больных ГБ. При анализе у больных ГБ из группы высокого риска развития ССО также обнаружена взаимосвязь уровней СРБ и МКСК (r=0,43; p=0,01), а у больных из группы низкого риска развития ССО аналогичная взаимосвязь не выявлена. Установлено, что у больных ГБ начиная с уровня МКСК >319 мкмоль/л отмечается повышение уровня СРБ, обнаруживаются микроальбуминурия, гиперурикозурия и клубочковая гиперфильтрация. Заключение. Можно полагать, что с уровня МКСК 319 мкмоль/л начинается активизация процессов неспецифического воспаления, которое в первую очередь затрагивает микрососуды почек.

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Copyright (c) 2020 Dmitriev V.A., Oshchepkova E.V., Titov V.N., Rogoza A.N., Saidova M.A., Bolotova M.N., Gushchina O.V., Polevaia T.I.

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