Preventive Treatment of Hyperuricemia Seems Unnecessary for Asymptomatic Individuals
In recent years, there has been an increase in the prevalence of hyperuricemia, and this constellation has drawn attention to an adult lifestyle-associated diseases including cardiovascular diseases (CVDs). Is there a possible link between hyperuricemia and high blood pressure, stroke and heart disease.
Experimental studies show that crystals of sodium urate can be deposited on the vessel walls, including coronary arteries, and are responsible for alterations of endothelial function, oxidative stress, inflammation and platelet activation. However, there is no evidence yet to suggest that hyperuricemia is an independent risk factor for cardiovascular disease and that, as such, it is necessary to be treated.
In order to answer this enigma, an Australian team performed a prospective analysis considering the initial levels of uric acid of more than 4,000 participants and their cardiovascular risk during a 15-year follow-up.
The first highlight is the high prevalence of hyperuricemia in this cohort, consisting in part of patients with no history of cardiovascular disease (n = 3475) and patients with a history of CVD (n = 698). The average age of the first group was a 48-years and 62 for the second. Hyperuricemia affects 10.7% of all people included. After adjustment for age and gender, each increase in uricemia of 0.1 mmol / l was associated with an increase in total mortality (HR [Hazard Ratio] = 1.19; 95% from 1.04 to 1.36), cardiovascular mortality (1.27, 1.03 to 1.57) and risk of first cardiovascular incident (1.28; 1 , 13-1.44).
But this is not so simple, since lifestyle adjustment and other cardiovascular risk factors moderates this effect, which remains significant only for patients who, at the start of the study, has a history of gout or cardiovascular disease.
These results suggest that hyperuricemia is not an independent risk factor for cardiovascular disease. Its cardiovascular impact seems to vary during the development of cardiovascular disease. Preventive treatment of hyperuricemia seems unnecessary for asymptomatic individuals. On the other hand, the hypo-uricemic treatment can benefit the individuals monitored for cardiovascular disease and who show clinical signs of gout.
Reference
Nossent, Johannes, et al. "Asymptomatic hyperuricemia is not an independent risk factor for cardiovascular events or overall mortality in the general population of the Busselton Health Study." BMC Cardiovascular Disorders 16.1 (2016): 256.Tags: gout, CVD, hyperuricemia