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Association between serum uric acid, hypertension, vascular stiffness and subclinical atherosclerosis: data from the Brisighella Heart Study

Cicero, Arrigo F.G.a; Salvi, Paolob; D’Addato, Sergioa; Rosticci, Martinaa; Borghi, Claudioafor the Brisighella Heart Study group

doi: 10.1097/HJH.0b013e328365b916

Objective: Serum uric acid (SUA) levels correlate with many recognized cardiovascular risk factors, including age, male sex, hypertension, diabetes mellitus, hypertriglyceridemia, obesity, and insulin resistance. The aim of our study was to verify in a large well characterized population sample the relationship between SUA values, hypertension, arterial stiffness and subclinical atherosclerosis.

Methods: For this study, we selected 248 men and 371 women adult patients enrolled in the last Brisighella Heart Study population survey for which a full set of data were available and not consuming antihypertensive, antidiabetic, lipid-lowering and uric acid-lowering drugs. SUA and other available variables were related to blood pressure level, carotid-femoral pulse wave velocity (cfPWV) and carotid intima–media thickness (cIMT).

Results: Hypertension prevalence was strongly related to SUA quartiles: we found significant differences between the 2nd (23.0%) and the 3rd quartiles (36.4%; P vs. 2nd < 0.05), and between the 3rd and the 4th quartile (56.3%; P vs. 3rd < 0.05). Similarly, the metabolic syndrome prevalence increased significantly at 39.5% in the 3rd SUA quartile (P < 0.05 vs. 2nd) and at 58.9% in the 4th quartile (P < 0.05 vs. 3rd). Intima–media thickness gradually and significantly rose along quartiles of SUA (P for trend < 0.0001), in particular, it was 0.86 mm in the 1st quartile, 0.90 in the 2nd, 0.94 in the 3rd, and 0.97 in the last quartile, with significant differences between each quartiles (all P < 0.05). In multivariate regression analyses, SUA resulted to be significantly associated to hypertension and metabolic syndrome prevalence, and IMT. Even if a significant association between SUA and cfPWV was found in univariate analysis (P = 0.002), when adjusting for age, the trend became nonsignificant (0.20).

Conclusion: In the studied population sample, after adjustment for a large number of parameters, SUA appears to be significantly correlated to hypertension and IMT, but not to aortic stiffness.

aInternal Medicine, Aging and Kidney Disease Department, University of Bologna, Bologna

bDepartment of Cardiology, Istituto Auxologico Italiano, Milan, Italy

Correspondence to Professor Claudio Borghi, Hypertension Research Center Internal Medicine, Aging and Kidney disease Dept. Sant’Orsola-Malpighi Hospital, University of Bologna Via Albertoni, 15, 40138 Bologna, Italy. Tel: +39 0516363243; fax: +39 051391320; e-mail:

Abbreviations: ApoAI, apolipoprotein AI; ApoB, apolipoprotein B; BHS, Brisighella Heart Study; CfPWV, carotid-femoral pulse wave velocity; CIMT, carotid intima–media thickness; HDL-C, high-density lipoprotein-cholesterol; LDL-C, low-density lipoprotein-cholesterol; Lp(a), Lipoprotein (a); RR, relative risk; SUA, serum uric acid; TC, total cholesterol; TG, triglycerides

Received 15 March, 2013

Revised 30 July, 2013

Accepted 9 August, 2013

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins