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Published in: BMC Cardiovascular Disorders 1/2012

Open Access 01-12-2012 | Research article

Relationship between serum uric acid and internal carotid resistive index in hypertensive women: a cross-sectional study

Authors: José Alexandre Addeo Cipolli, Maria Carolina Ferreira-Sae, Rafael Prado Martins, José Alexandre Pio-Magalhães, Vera Regina Bellinazzi, José Roberto Matos-Souza, Wilson Nadruz Junior

Published in: BMC Cardiovascular Disorders | Issue 1/2012

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Abstract

Background

The impact of serum uric acid (SUA) on arteries of hypertensive subjects remains to be fully established. This study investigated the relationship between SUA and carotid structural and hemodynamic parameters in hypertensive men and women.

Methods

Three hundred and thirty eight patients (207 women and 131 men) were cross-sectionally evaluated by clinical, laboratory, hemodynamic and carotid ultrasound analysis. Common carotid diameters, circumferential wall tensions, Young’s Elastic Modulus, Stiffness Index, Arterial Compliance and intima-media thickness (IMT) were determined. Internal carotid artery resistive index (ICRI), a hemodynamic measure that reflects local vascular impedance and microangiopathy, was also assessed.

Results

Univariate analysis showed no significant correlation of SUA with carotid diameters, elasticity/stiffness indexes, IMT and circumferential wall tensions in both genders. Conversely, SUA correlated with ICRI (r = 0.34; p < 0.001) in women, but not in men, and hyperuricemic women presented higher ICRI than normouricemic ones (0.684 ± 0.007 vs. 0.649 ± 0.004; p < 0.001). Stepwise and logistic regression analyses adjusted for potential confounding factors showed that ICRI was independently associated with SUA and hyperuricemia in women.

Conclusions

This study demonstrated that SUA was associated with ICRI in hypertensive women, suggesting that there might gender-related differences in the relationship between SUA and vascular damage in subjects with systemic hypertension.
Literature
2.
go back to reference Johnson RJ, Kang DH, Feig D, Kivlighn S, Kanellis J, Watanabe S, Tuttle KR, Rodriguez-Iturbe B, Herrera-Acosta J, Mazzali M: Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease?. Hypertension. 2003, 41: 1183-1190. 10.1161/01.HYP.0000069700.62727.C5.CrossRefPubMed Johnson RJ, Kang DH, Feig D, Kivlighn S, Kanellis J, Watanabe S, Tuttle KR, Rodriguez-Iturbe B, Herrera-Acosta J, Mazzali M: Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease?. Hypertension. 2003, 41: 1183-1190. 10.1161/01.HYP.0000069700.62727.C5.CrossRefPubMed
3.
go back to reference Viazzi F, Leoncini G, Ratto E, Pontremoli R: Serum uric acid as a risk factor for cardiovascular and renal disease: an old controversy revived. J Clin Hypertens. 2006, 8: 510-518. 10.1111/j.1524-6175.2006.04755.x.CrossRef Viazzi F, Leoncini G, Ratto E, Pontremoli R: Serum uric acid as a risk factor for cardiovascular and renal disease: an old controversy revived. J Clin Hypertens. 2006, 8: 510-518. 10.1111/j.1524-6175.2006.04755.x.CrossRef
4.
go back to reference Tavil Y, Kaya MG, Oktar SO, Sen N, Okyay K, Yazici HU, Cengel A: Uric acid level and its association with carotid intima-media thickness in patients with hypertension. Atherosclerosis. 2008, 197: 159-163. 10.1016/j.atherosclerosis.2007.03.008.CrossRefPubMed Tavil Y, Kaya MG, Oktar SO, Sen N, Okyay K, Yazici HU, Cengel A: Uric acid level and its association with carotid intima-media thickness in patients with hypertension. Atherosclerosis. 2008, 197: 159-163. 10.1016/j.atherosclerosis.2007.03.008.CrossRefPubMed
5.
go back to reference Vlachopoulos C, Xaplanteris P, Vyssoulis G, Bratsas A, Baou K, Tzamou V, Aznaouridis K, Dima I, Lazaros G, Stefanadis C: Association of serum uric acid level with aortic stiffness and arterial wave reflections in newly diagnosed, never-treated hypertension. Am J Hypertens. 2011, 24: 33-39. 10.1038/ajh.2010.111.CrossRefPubMed Vlachopoulos C, Xaplanteris P, Vyssoulis G, Bratsas A, Baou K, Tzamou V, Aznaouridis K, Dima I, Lazaros G, Stefanadis C: Association of serum uric acid level with aortic stiffness and arterial wave reflections in newly diagnosed, never-treated hypertension. Am J Hypertens. 2011, 24: 33-39. 10.1038/ajh.2010.111.CrossRefPubMed
6.
go back to reference Tsai WC, Huang YY, Lin CC, Li WT, Lee CH, Chen JY, Chen JH: Uric acid is an independent predictor of arterial stiffness in hypertensive patients. Hear Vessel. 2009, 24: 371-375. 10.1007/s00380-008-1127-9.CrossRef Tsai WC, Huang YY, Lin CC, Li WT, Lee CH, Chen JY, Chen JH: Uric acid is an independent predictor of arterial stiffness in hypertensive patients. Hear Vessel. 2009, 24: 371-375. 10.1007/s00380-008-1127-9.CrossRef
7.
go back to reference Cuspidi C, Valerio C, Sala C, Meani S, Esposito A, Zanchetti A, Mancia G: Lack of association between serum uric acid and organ damage in a never-treated essential hypertensive population at low prevalence of hyperuricemia. Am J Hypertens. 2007, 20: 678-685. 10.1016/j.amjhyper.2007.01.013.CrossRefPubMed Cuspidi C, Valerio C, Sala C, Meani S, Esposito A, Zanchetti A, Mancia G: Lack of association between serum uric acid and organ damage in a never-treated essential hypertensive population at low prevalence of hyperuricemia. Am J Hypertens. 2007, 20: 678-685. 10.1016/j.amjhyper.2007.01.013.CrossRefPubMed
8.
go back to reference Tsioufis C, Kyvelou S, Dimitriadis K, Syrseloudis D, Sideris S, Skiadas I, Katsi V, Stefanadi E, Lalos S, Mihas C, Poulakis M, Stefanadis C: The diverse associations of uric acid with low-grade inflammation, adiponectin and arterial stiffness in never-treated hypertensives. J Hum Hypertens. 2011, 25: 554-559. 10.1038/jhh.2010.98.CrossRefPubMed Tsioufis C, Kyvelou S, Dimitriadis K, Syrseloudis D, Sideris S, Skiadas I, Katsi V, Stefanadi E, Lalos S, Mihas C, Poulakis M, Stefanadis C: The diverse associations of uric acid with low-grade inflammation, adiponectin and arterial stiffness in never-treated hypertensives. J Hum Hypertens. 2011, 25: 554-559. 10.1038/jhh.2010.98.CrossRefPubMed
9.
go back to reference Staub D, Meyerhans A, Bundi B, Schmid HP, Frauchiger B: Prediction of cardiovascular morbidity and mortality: comparison of the internal carotid artery resistive index with the common carotid artery intima-media thickness. Stroke. 2006, 37: 800-805. 10.1161/01.STR.0000202589.47401.c6.CrossRefPubMed Staub D, Meyerhans A, Bundi B, Schmid HP, Frauchiger B: Prediction of cardiovascular morbidity and mortality: comparison of the internal carotid artery resistive index with the common carotid artery intima-media thickness. Stroke. 2006, 37: 800-805. 10.1161/01.STR.0000202589.47401.c6.CrossRefPubMed
10.
go back to reference Berni A, Boddi M, Fattori EB, Cecioni I, Berardino S, Montuschi F, Chiostri M, Poggesi L: Serum uric acid levels and renal damage in hyperuricemic hypertensive patients treated with renin-angiotensin system blockers. Am J Hypertens. 2010, 23: 675-680. 10.1038/ajh.2010.33.CrossRefPubMed Berni A, Boddi M, Fattori EB, Cecioni I, Berardino S, Montuschi F, Chiostri M, Poggesi L: Serum uric acid levels and renal damage in hyperuricemic hypertensive patients treated with renin-angiotensin system blockers. Am J Hypertens. 2010, 23: 675-680. 10.1038/ajh.2010.33.CrossRefPubMed
11.
go back to reference Viazzi F, Leoncini G, Ratto E, Falqui V, Parodi A, Conti N, Derchi LE, Tomolillo C, Deferrari G, Pontremoli R: Mild hyperuricemia and subclinical renal damage in untreated primary hypertension. Am J Hypertens. 2007, 20: 1276-1282. 10.1016/j.amjhyper.2007.08.010.CrossRefPubMed Viazzi F, Leoncini G, Ratto E, Falqui V, Parodi A, Conti N, Derchi LE, Tomolillo C, Deferrari G, Pontremoli R: Mild hyperuricemia and subclinical renal damage in untreated primary hypertension. Am J Hypertens. 2007, 20: 1276-1282. 10.1016/j.amjhyper.2007.08.010.CrossRefPubMed
12.
go back to reference Hoieggen A, Alderman MH, Kjeldsen SE, Julius S, Devereux RB, De Faire U, Fyhrquist F, Ibsen H, Kristianson K, Lederballe-Pedersen O, Lindholm LH, Nieminen MS, Omvik P, Oparil S, Wedel H, Chen C, Dahlöf B, LIFE Study Group: The impact of serum uric acid on cardiovascular outcomes in the LIFE study. Kidney Int. 2004, 65: 1041-1049. 10.1111/j.1523-1755.2004.00484.x.CrossRefPubMed Hoieggen A, Alderman MH, Kjeldsen SE, Julius S, Devereux RB, De Faire U, Fyhrquist F, Ibsen H, Kristianson K, Lederballe-Pedersen O, Lindholm LH, Nieminen MS, Omvik P, Oparil S, Wedel H, Chen C, Dahlöf B, LIFE Study Group: The impact of serum uric acid on cardiovascular outcomes in the LIFE study. Kidney Int. 2004, 65: 1041-1049. 10.1111/j.1523-1755.2004.00484.x.CrossRefPubMed
13.
go back to reference Heo SH, Lee SH: High levels of serum uric acid are associated with silent brain infarction. J Neurol Sci. 2010, 297: 6-10. 10.1016/j.jns.2010.07.007.CrossRefPubMed Heo SH, Lee SH: High levels of serum uric acid are associated with silent brain infarction. J Neurol Sci. 2010, 297: 6-10. 10.1016/j.jns.2010.07.007.CrossRefPubMed
14.
go back to reference Pio-Magalhães JA, Cornélio M, Leme CA, Matos-Souza JR, Garlipp CR, Gallani MC, Rodrigues RC, Franchini KG, Nadruz W: Upper arm circumference is an independent predictor of left ventricular concentric hypertrophy in hypertensive women. Hypertens Res. 2008, 31: 1177-1183. 10.1291/hypres.31.1177.CrossRefPubMed Pio-Magalhães JA, Cornélio M, Leme CA, Matos-Souza JR, Garlipp CR, Gallani MC, Rodrigues RC, Franchini KG, Nadruz W: Upper arm circumference is an independent predictor of left ventricular concentric hypertrophy in hypertensive women. Hypertens Res. 2008, 31: 1177-1183. 10.1291/hypres.31.1177.CrossRefPubMed
15.
go back to reference Zhu Y, Pandya BJ, Choi HK: Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007–2008. Arthritis Rheum. 2011, 63: 3136-3141. 10.1002/art.30520.CrossRefPubMed Zhu Y, Pandya BJ, Choi HK: Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007–2008. Arthritis Rheum. 2011, 63: 3136-3141. 10.1002/art.30520.CrossRefPubMed
16.
go back to reference Summary E: The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation And Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001, 285: 2486-2497. 10.1001/jama.285.19.2486.CrossRef Summary E: The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation And Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001, 285: 2486-2497. 10.1001/jama.285.19.2486.CrossRef
17.
go back to reference Cipolli JA, Souza FA, Ferreira-Sae MC, Pio-Magalhães JA, Figueiredo ES, Vidotti VG, Matos-Souza JR, Franchini KG, Nadruz W: Sex-specific hemodynamic and non-hemodynamic determinants of aortic root size in hypertensive subjects with left ventricular hypertrophy. Hypertens Res. 2009, 32: 956-961. 10.1038/hr.2009.134.CrossRefPubMed Cipolli JA, Souza FA, Ferreira-Sae MC, Pio-Magalhães JA, Figueiredo ES, Vidotti VG, Matos-Souza JR, Franchini KG, Nadruz W: Sex-specific hemodynamic and non-hemodynamic determinants of aortic root size in hypertensive subjects with left ventricular hypertrophy. Hypertens Res. 2009, 32: 956-961. 10.1038/hr.2009.134.CrossRefPubMed
18.
go back to reference Ferreira-Sae MC, Cipolli JA, Cornélio ME, Matos-Souza JR, Fernandes MN, Schreiber R, Costa FO, Franchini KG, Rodrigues RC, Gallani MC, Nadruz W: Sodium intake is associated with carotid artery structure alterations and plasma matrix metalloproteinase-9 upregulation in hypertensive adults. J Nutr. 2011, 141: 877-882. 10.3945/jn.110.135921.CrossRefPubMed Ferreira-Sae MC, Cipolli JA, Cornélio ME, Matos-Souza JR, Fernandes MN, Schreiber R, Costa FO, Franchini KG, Rodrigues RC, Gallani MC, Nadruz W: Sodium intake is associated with carotid artery structure alterations and plasma matrix metalloproteinase-9 upregulation in hypertensive adults. J Nutr. 2011, 141: 877-882. 10.3945/jn.110.135921.CrossRefPubMed
19.
go back to reference Hernesniemi JA, Raitakari OT, Kähönen M, Juonala M, Hutri-Kähönen N, Marniemi J, Viikari J, Lehtimäki T: Toll-like receptor 4 gene (Asp299Gly) polymorphism associates with carotid artery elasticity. The cardiovascular risk in young Finns study. Atherosclerosis. 2008, 198: 152-159. 10.1016/j.atherosclerosis.2007.09.024.CrossRefPubMed Hernesniemi JA, Raitakari OT, Kähönen M, Juonala M, Hutri-Kähönen N, Marniemi J, Viikari J, Lehtimäki T: Toll-like receptor 4 gene (Asp299Gly) polymorphism associates with carotid artery elasticity. The cardiovascular risk in young Finns study. Atherosclerosis. 2008, 198: 152-159. 10.1016/j.atherosclerosis.2007.09.024.CrossRefPubMed
20.
go back to reference Gemignani T, Matos-Souza JR, Coelho OR, Franchini KG, Nadruz W: Postural changes may influence popliteal atherosclerosis by modifying local circumferential wall tension. Hypertens Res. 2008, 31: 2059-2064. 10.1291/hypres.31.2059.CrossRefPubMed Gemignani T, Matos-Souza JR, Coelho OR, Franchini KG, Nadruz W: Postural changes may influence popliteal atherosclerosis by modifying local circumferential wall tension. Hypertens Res. 2008, 31: 2059-2064. 10.1291/hypres.31.2059.CrossRefPubMed
21.
go back to reference Feig DI, Soletsky B, Johnson RJ: Effect of allopurinol on the blood pressure of adolescents with newly diagnosed essential hypertension. JAMA. 2008, 300: 924-932. 10.1001/jama.300.8.924.CrossRefPubMedPubMedCentral Feig DI, Soletsky B, Johnson RJ: Effect of allopurinol on the blood pressure of adolescents with newly diagnosed essential hypertension. JAMA. 2008, 300: 924-932. 10.1001/jama.300.8.924.CrossRefPubMedPubMedCentral
22.
go back to reference Farquharson CA, Butler R, Hill A, Belch JJ, Struthers AD: Allopurinol improves endothelial dysfunction in chronic heart failure. Circulation. 2002, 106: 221-226. 10.1161/01.CIR.0000022140.61460.1D.CrossRefPubMed Farquharson CA, Butler R, Hill A, Belch JJ, Struthers AD: Allopurinol improves endothelial dysfunction in chronic heart failure. Circulation. 2002, 106: 221-226. 10.1161/01.CIR.0000022140.61460.1D.CrossRefPubMed
23.
go back to reference Siu YP, Leung KT, Tong MK, Kwan TH: Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis. 2006, 47: 51-59. 10.1053/j.ajkd.2005.10.006.CrossRefPubMed Siu YP, Leung KT, Tong MK, Kwan TH: Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis. 2006, 47: 51-59. 10.1053/j.ajkd.2005.10.006.CrossRefPubMed
24.
go back to reference Lee MY, Wu CM, Chu CS, Lee KT, Sheu SH, Lai WT: Association of carotid hemodynamics with risk of coronary heart disease in a Taiwanese population with essential hypertension. Am J Hypertens. 2008, 21: 696-700. 10.1038/ajh.2008.160.CrossRefPubMed Lee MY, Wu CM, Chu CS, Lee KT, Sheu SH, Lai WT: Association of carotid hemodynamics with risk of coronary heart disease in a Taiwanese population with essential hypertension. Am J Hypertens. 2008, 21: 696-700. 10.1038/ajh.2008.160.CrossRefPubMed
25.
go back to reference Frauchiger B, Schmid HP, Roedel C, Moosmann P, Staub D: Comparison of carotid arterial resistive indices with intima-media thickness as sonographic markers of atherosclerosis. Stroke. 2001, 32: 836-841. 10.1161/01.STR.32.4.836.CrossRefPubMed Frauchiger B, Schmid HP, Roedel C, Moosmann P, Staub D: Comparison of carotid arterial resistive indices with intima-media thickness as sonographic markers of atherosclerosis. Stroke. 2001, 32: 836-841. 10.1161/01.STR.32.4.836.CrossRefPubMed
26.
go back to reference Culleton BF: Uric acid and cardiovascular disease: a renal–cardiac relationship?. Curr Opin Nephrol Hypertens. 2001, 10: 371-375. 10.1097/00041552-200105000-00012.CrossRefPubMed Culleton BF: Uric acid and cardiovascular disease: a renal–cardiac relationship?. Curr Opin Nephrol Hypertens. 2001, 10: 371-375. 10.1097/00041552-200105000-00012.CrossRefPubMed
27.
go back to reference Hak AE, Choi HK: Menopause, postmenopausal hormone use and serum uric acid levels in US women–the Third National Health and Nutrition Examination Survey. Arthritis Res Ther. 2008, 10: R116-10.1186/ar2519.CrossRefPubMedPubMedCentral Hak AE, Choi HK: Menopause, postmenopausal hormone use and serum uric acid levels in US women–the Third National Health and Nutrition Examination Survey. Arthritis Res Ther. 2008, 10: R116-10.1186/ar2519.CrossRefPubMedPubMedCentral
28.
go back to reference Paini A, Boutouyrie P, Calvet D, Tropeano AI, Laloux B, Laurent S: Carotid and aortic stiffness: determinants of discrepancies. Hypertension. 2006, 47: 371-376. 10.1161/01.HYP.0000202052.25238.68.CrossRefPubMed Paini A, Boutouyrie P, Calvet D, Tropeano AI, Laloux B, Laurent S: Carotid and aortic stiffness: determinants of discrepancies. Hypertension. 2006, 47: 371-376. 10.1161/01.HYP.0000202052.25238.68.CrossRefPubMed
29.
go back to reference Takayama S, Kawamoto R, Kusunoki T, Abe M, Onji M: Uric acid is an independent risk factor for carotid atherosclerosis in a Japanese elderly population without metabolic syndrome. Cardiovasc Diabetol. 2012, 11: 2-10.1186/1475-2840-11-2.CrossRefPubMedPubMedCentral Takayama S, Kawamoto R, Kusunoki T, Abe M, Onji M: Uric acid is an independent risk factor for carotid atherosclerosis in a Japanese elderly population without metabolic syndrome. Cardiovasc Diabetol. 2012, 11: 2-10.1186/1475-2840-11-2.CrossRefPubMedPubMedCentral
30.
go back to reference Ishizaka N, Ishizaka Y, Toda E, Nagai R, Yamakado M: Association between serum uric acid, metabolic syndrome, and carotid atherosclerosis in Japanese individuals. Arterioscler Thromb Vasc Biol. 2005, 25: 1038-1044. 10.1161/01.ATV.0000161274.87407.26.CrossRefPubMed Ishizaka N, Ishizaka Y, Toda E, Nagai R, Yamakado M: Association between serum uric acid, metabolic syndrome, and carotid atherosclerosis in Japanese individuals. Arterioscler Thromb Vasc Biol. 2005, 25: 1038-1044. 10.1161/01.ATV.0000161274.87407.26.CrossRefPubMed
31.
go back to reference Sica DA, Carter B, Cushman W, Hamm L: Thiazide and loop diuretics. J Clin Hypertens. 2011, 13: 639-643. 10.1111/j.1751-7176.2011.00512.x.CrossRef Sica DA, Carter B, Cushman W, Hamm L: Thiazide and loop diuretics. J Clin Hypertens. 2011, 13: 639-643. 10.1111/j.1751-7176.2011.00512.x.CrossRef
32.
go back to reference Würzner G, Gerster JC, Chiolero A, Maillard M, Fallab-Stubi CL, Brunner HR, Burnier M: Comparative effects of losartan and irbesartan on serum uric acid in hypertensive patients with hyperuricaemia and gout. J Hypertens. 2001, 19: 1855-1860. 10.1097/00004872-200110000-00021.CrossRefPubMed Würzner G, Gerster JC, Chiolero A, Maillard M, Fallab-Stubi CL, Brunner HR, Burnier M: Comparative effects of losartan and irbesartan on serum uric acid in hypertensive patients with hyperuricaemia and gout. J Hypertens. 2001, 19: 1855-1860. 10.1097/00004872-200110000-00021.CrossRefPubMed
Metadata
Title
Relationship between serum uric acid and internal carotid resistive index in hypertensive women: a cross-sectional study
Authors
José Alexandre Addeo Cipolli
Maria Carolina Ferreira-Sae
Rafael Prado Martins
José Alexandre Pio-Magalhães
Vera Regina Bellinazzi
José Roberto Matos-Souza
Wilson Nadruz Junior
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2012
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/1471-2261-12-52

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