Association between hyperuricemia and incident heart failure among older adults: A propensity-matched study

作者：Ekundayo O James; Dell'Italia Louis J; Sanders Paul W; Arnett Donna; Aban Inmaculada; Love Thomas E; Filippatos Gerasimos; Anker Stefan D; Lloyd Jones Donald M; Bakris George; Mujib Marjan; Ahmed Ali^*

来源：International Journal of Cardiology, 2010, 142(3): 279-287.

DOI：10.1016/j.ijcard.2009.01.010

• Uric acid
• Incident heart failure
• Kidney function
• Propensity score

Background: The association between hyperuricemia and incident heart failure (HF) is relatively unknown.
Methods: Of the 5461 community-dwelling older adults, >= 65 years, in the Cardiovascular Health Study without HF at baseline, 1505 had hyperuricemia (baseline serum uric acid >= 6 mg/dL for women and >= 7 mg/dL for men). Using propensity scores for hyperuricemia, estimated for each participant using 64 baseline covariates, we were able to match 1181 pairs of participants with and without hyperuricemia.
Results: Incident HF occurred in 21% and 18% of participants respectively with and without hyperuricemia during 8.1 years of mean follow-up (hazard ratio {HR} for hyperuricemia versus no hyperuricemia, 1.30; 95% confidence interval {CI}, 1.05-1.60; P=0.015). The association between hyperuricemia and incident HF was significant only in subgroups with normal kidney HR, 1.23; 95% CI, 1.02-1.49; P=0.031), without hypertension (HR, 1.31; 95% CI, 1.03-1.66; P=0.030), not receiving thiazide diuretics (HR, 1.20; 95% CI, 1.01-1.42; P=0.044), and without hyperinsulinemia (HR, 1.35; 95% CI, 1.06-1.72; P=0.013). Used as a continuous variable, each 1 mg/dL increase in serum uric acid was associated with a 12% increase in incident HF (HR, 1.12; 95% CI, 1.03-1.22; P=0.006). Hyperuricemia had no association with acute myocardial infarction or all-cause mortality.
Conclusions: Hyperuricemia is associated with incident HF in community-dwelling older adults. Cumulative data from our subgroup analyses suggest that this association is only significant when hyperuricemia is a marker of increased xanthine oxidase activity but not when hyperuricemia is caused by impaired renal elimination of uric acid. Published by Elsevier Ireland Ltd.

• 出版日期2010-7-23
• 单位西北大学