The Role of Uric Acid in the Pathogenesis of Hypertension in the Young

被引:77
作者
Feig, Daniel I. [1 ]
机构
[1] Univ Alabama Birmingham, Dept Pediat, Div Nephrol, Birmingham, AL USA
关键词
HIGH-BLOOD-PRESSURE; EXCESSIVE FRUCTOSE INTAKE; CORONARY-HEART-DISEASE; SMOOTH-MUSCLE-CELLS; INCIDENT HYPERTENSION; ATHEROSCLEROSIS RISK; HYPERURICEMIA; LEVEL; MEN; ALLOPURINOL;
D O I
10.1111/j.1751-7176.2012.00662.x
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
J Clin Hypertens (Greenwich). 2012; 14:346352. (C) 2012 Wiley Periodicals, Inc. Uric acid has been suspected to be a risk factor for hypertension since the 1870s. Numerous epidemiological studies demonstrate an association between uric acid and both incident and prevalent hypertension in diverse populations. Studies in elderly patients have had more variable results, raising the possibility that uric acid may be more significant to hypertension in the young. Animal models support a two-phase mechanism for the development of hyperuricemic hypertension. Initially, uric acid induces vasoconstriction by activation of the renin-angiotensin system and reduction of circulating nitric oxide, which can be reversed by lowering uric acid. Over time, uric acid uptake into vascular smooth muscle cells causes cellular proliferation and secondary arteriolosclerosis that impairs pressure natriuresis, causing sodium-sensitive hypertension. Consistent with the animal model data, small clinical trials performed in adolescents with newly diagnosed essential hypertension demonstrate that at least in certain young patients, reduction of serum uric acid can mitigate blood pressure elevation. While more research is clearly necessary, the available data suggest that uric acid is likely causative in some cases of early-onset hypertension.
引用
收藏
页码:346 / 352
页数:7
相关论文
共 76 条
[1]   Childhood uric acid predicts adult blood pressure - The Bogalusa Heart Study [J].
Alper, AB ;
Chen, W ;
Yau, L ;
Srinivasan, SR ;
Berenson, GS ;
Hamm, LL .
HYPERTENSION, 2005, 45 (01) :34-38
[2]  
[Anonymous], PEDIATRIIA
[3]  
[Anonymous], JAMA
[4]  
[Anonymous], ARCH INTERN MED
[5]  
[Anonymous], COMPTES RENDUS ACAD
[6]   HYPERURICEMIA AS A RISK FACTOR OF CORONARY HEART-DISEASE - THE FRAMINGHAM-STUDY [J].
BRAND, FN ;
MCGEE, DL ;
KANNEL, WB ;
STOKES, J ;
CASTELLI, WP .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1985, 121 (01) :11-18
[7]   Fructose ingestion acutely elevates blood pressure in healthy young humans [J].
Brown, Clive M. ;
Dulloo, Abdul G. ;
Yepuri, Gayathri ;
Montani, Jean-Pierre .
AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY, 2008, 294 (03) :R730-R737
[8]  
Cannella AC, 2005, AM J MANAG CARE, V11, pS451
[9]   Reducing Consumption of Sugar-Sweetened Beverages Is Associated With Reduced Blood Pressure A Prospective Study Among United States Adults [J].
Chen, Liwei ;
Caballero, Benjamin ;
Mitchell, Diane C. ;
Loria, Catherine ;
Lin, Pao-Hwa ;
Champagne, Catherine M. ;
Elmer, Patricia J. ;
Ard, Jamy D. ;
Batch, Bryan C. ;
Anderson, Cheryl A. M. ;
Appel, Lawrence J. .
CIRCULATION, 2010, 121 (22) :2398-2406
[10]   Serum uric acid and risk for cardiovascular disease and death: The Framingham Heart Study [J].
Culleton, BF ;
Larson, MG ;
Kannel, WB ;
Levy, D .
ANNALS OF INTERNAL MEDICINE, 1999, 131 (01) :7-+