Uric acid and hypertension: a focused review and practical recommendations

被引:67
作者
De Becker, Benjamin [1 ]
Borghi, Claudio [2 ]
Burnier, Michel [3 ]
van de Borne, Philippe [1 ]
机构
[1] Univ Libre Bruxelles, Hop Erasme, Serv Cardiol, Route Lennik 808, B-1070 Brussels, Belgium
[2] St Orsola Marcello Malpighi Hosp, Unita Operat Med Interna, Bologna, Italy
[3] CHU Vaudois, Serv Nephrol & Hypertens, Lausanne, Switzerland
关键词
hypertension; hyperuricemia; oxidative stress; xanthine oxidoreductase; BLOOD-PRESSURE; ENDOTHELIAL DYSFUNCTION; CARDIOVASCULAR-DISEASE; INCIDENT HYPERTENSION; SERUM URATE; RISK-FACTOR; HYPERURICEMIA; ALLOPURINOL; ASSOCIATION; POPULATION;
D O I
10.1097/HJH.0000000000001980
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Uric acid levels are higher in humans than in other mammals. Best known as an extracellular antioxidant, uric acid also increases salt sensitivity, fat storage, and lipogenesis. Xanthine oxidase-related oxidative stress may also induce endothelial dysfunction and renal vasoconstriction. Renal structure abnormalities contribute to salt-sensitive and uric acid-independent hypertension. Maternal hyperuricemia during pregnancy and hyperuricemia early in life are likewise independent risk factors for hypertension. Genetic polymorphism is potentially involved in the activity of xanthine oxidoreductase, but further studies are needed. Xanthine oxidase inhibition consistently decreases blood pressure in younger hypertensive patients, albeit modestly. Hyperuricemia affects one out of five adults as a result of the Western diet, insulin resistance, and renal dysfunction. This review advocates lifestyle changes to maintain uric acid levels within the normal range in young (pre) hypertensive individuals or normotensives with a family history of hypertension, metabolic disorders, or obesity; moreover, antihypertensive medications that increase uric acid levels should be avoided.
引用
收藏
页码:878 / 883
页数:6
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