Uric Acid and New Onset Left Ventricular Hypertrophy: Findings From the PAMELA Population

作者：Cuspidi Cesare; Facchetti Rita; Bombelli Michele; Sala Carla; Tadic Marijana; Grassi Guido; Mancia Giuseppe

来源：American Journal of Hypertension, 2017, 30(3): 279-285.

DOI：10.1093/ajh/hpw159

• blood pressure
• echocardiography
• general population
• hypertension
• left ventricular hypertrophy
• serum uric acid

BACKGROUND
The association between serum uric acid (SUA) and left ventricular hypertrophy (LVH) is controversial and the ability of SUA in predicting incident LVH remains unsettled. Thus, we evaluated the relationship of SUA with new-onset echocardiographic LVH over a 10-year period in subjects of the general population enrolled in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study.
METHODS
The study included 960 subjects with normal LV mass index (LVMI) at baseline echocardiographic evaluation and a readable echocardiogram at the end of follow-up. Cut-points for LVH were derived from reference values of the healthy fraction of the PAMELA population.
RESULTS
Over a 10-year period, 258 participants (26.9%) progressed to LVH. The incidence of new-onset LVH increased from the lowest (23%) to intermediate (25%) and the highest baseline SUA tertile (32%). After adjusting for confounders (not including body mass index (BMI)), each 1 mg/dl increase in SUA entailed a 26% higher risk of incident LVH. Adjusted odd ratio of LVH risk in the highest SUA tertile was 96% higher than in the lowest tertile (odds ratio (OR) = 1.966, 95% CI = 1.158-3.339, P = 0.0123). Correction for BMI reduced the magnitude and statistical significance of ORs.
CONCLUSIONS
The study shows that SUA is a predictor of long-term echocardiographic changes from normal LVMI to LVH in a community sample. Thus, life-style and pharmacologic measures aimed to reduce SUA levels may concur to preventing LVH development in the general population.

• 出版日期2017-3