Update in uric acid, hypertension, and cardiovascular diseases

被引:58
作者
Kuwabara, Masanari [1 ]
Kodama, Takahide [1 ]
Ae, Ryusuke [2 ]
Kanbay, Mehmet [3 ]
Andres-Hernando, Ana [4 ]
Borghi, Claudio [5 ]
Hisatome, Ichiro [6 ]
Lanaspa, Miguel A. [4 ]
机构
[1] Toranomon Gen Hosp, Dept Cardiol, Tokyo, Japan
[2] Jichi Med Univ, Ctr Community Med, Div Publ Hlth, Tochigi, Japan
[3] Koc Univ, Dept Med, Div Nephrol, Sch Med, Istanbul, Turkiye
[4] Univ Colorado Denver, Sch Med, Div Endocrinol Metab & Diabet, Aurora, CO USA
[5] Univ Bologna, Dept Med & Surg Sci, Bologna, Italy
[6] Yonago Med Ctr, Dept Cardiol, Torrori, Japan
关键词
Uric acid; Hypertension; Cardiovascular renal metabolic diseases; Causality; Risk factor; CHRONIC KIDNEY-DISEASE; XANTHINE-OXIDASE INHIBITION; HEART-FAILURE PATIENTS; BLOOD-PRESSURE; ATRIAL-FIBRILLATION; ASYMPTOMATIC HYPERURICEMIA; CARDIOMETABOLIC DISEASES; JAPANESE GUIDELINE; METABOLIC SYNDROME; POTENTIAL-ROLE;
D O I
10.1038/s41440-023-01273-3
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
A direct relationship between serum uric acid levels and hypertension, cardiovascular, renal and metabolic diseases has been reported in many basic and epidemiological studies. Among these, high blood pression is one of the most common features associated with hyperuricemia. In this regard, several small-scale interventional studies have demonstrated a significant reduction in blood pressure in hypertensive or prehypertensive patients on uric acid-lowering drugs. These observation or intervention studies have led to affirm that there is a causal relationship between uric acid and hypertension. While the clinical association between uric acid and high blood pressure is notable, no clear conclusion has yet been reached as to whether lowering uric acid is beneficial to prevent cardiovascular and renal metabolic diseases. Recently, several prospective randomized controlled intervention trials using allopurinol and other uric acid-lowering drugs have been reported, and the results from these trials were almost negative, suggesting that the correlation between hyperuricemia and cardiovascular disease has no causality. However, it is important to note that in some of these recent studies there were high dropout rates and an important fraction of participants were not hyperuricemic. Therefore, we should carry caution in interpreting the results of these studies. This review article presents the results of recent clinical trials using uric acid-lowering drugs, focusing on hypertension and cardiovascular and renal metabolic diseases, and discusses the future of uric acid therapy.
引用
收藏
页码:1714 / 1726
页数:13
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