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Uric acid, an independent risk factor for endothelial dysfunction

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Background: Previous studies have raised the possibility that uric acid might be an independent, causal risk factor for cardiovascular disease. The aim of the study was to evaluate the relationship between uric acid and endothelial function in patients with hypertension.

Methods: A total of 106 newly diagnosed never treated patients with uncomplicated essential hypertension (56 men, mean age 49, 6 +-6,8y) were studied. Classical risk factors, uric acid, creatinine and C reactive protein were determined. Endothelial function was estimated by flow-mediated dilatation of the brachial artery. Patients were distributed in two groups: high uric acid ė 5 mg dl (n=49) and low uric acid < 5 mg dl (n=57).

Results: Patients with high uric acid were older (p=0,002), had higher systolic blood pressure (p< 0,001), higher creatinine (p< 0,01) and higher C reactive protein (p=0, 05). Flow mediated dilation was markedly lower in patients with high uric acid (5,77 +-1,55%) vs (7,57+-1,23%) (p< 0, 0001). In multiple regression analysis independent predictors for flow mediated dilation were: creatinine (r= – 0, 67, p< 0, 0001), uric acid (r= – 0, 64, p=0, 0002) and systolic blood pressure (r= – 0,56,p=0,0015) (R2=0,73).

Conclusions: Hyperuricemia in patients with essential hypertension is associated with endothelial dysfunction. This association is independent of classical risk factors and C reactive protein and may contribute to cardiovascular morbidity. Uric acid represents a possible new target for the reduction of morbidity and mortality associated with hypertension and cardiovascular disease. Abbreviations: BMI=body mass index, CRP= C reactive protein, DBP=diastolic blood pressure, FMD = flow mediated dilation, SBP=systolic blood pressure, UA=uric acid.

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Emilia Babes and Vlad Babes

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