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Serum uric acid is independently associated with hypertension in patients with rheumatoid arthritis

Journal of Human Hypertension volume 22, pages 177–182 (2008)Cite this article

Abstract

Hypertension (HT) is highly prevalent in rheumatoid arthritis (RA). Serum uric acid (SUA) has been associated with HT in the general population. The mutual exclusion of gout and RA, and the systemic inflammatory component of RA may alter this association in this patient population. We explored a potential association between SUA levels and HT in RA and evaluated whether this association is independent of HT risk factors, RA characteristics and relevant drugs. A total of 400 consecutive RA patients were assessed. SUA and complete biochemical profile were measured. Demographic, HT-related factors, RA characteristics and drugs were assessed as potential covariates. Results were analysed using binary logistic models to test the independence of the association between SUA and HT. SUA levels were higher in hypertensive compared to normotensive RA patients (5.44±1.6 mg dl−1 (323.57±95.17 μmol l−1) vs 4.56±1.1 mg dl−1 (271.23±65.43 μmol l−1), P<0.001). When adjusted for HT risk factors, renal function, RA characteristics, non-steroidal anti-inflammatory drugs, oral prednisolone, cyclosporine, leflunomide and low-dose aspirin, the odds of being a hypertensive RA patient per 1 mg dl−1(59.48 μmol l−1) SUA increase were significantly increased: OR=1.59 (95% CI: 1.21–2.1, P=0.001). This was also significant for the subgroup of patients who were not on diuretics (OR=1.5, 95% CI: 1.1–2.05; P=0.011). This cross-sectional study suggests that SUA levels are independently associated with HT in RA patients. Prospective longitudinal studies are needed to confirm and further explore the causes and implications of this association.

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Acknowledgements

This study was funded by the Dudley Group of Hospitals R&D Directorate cardiovascular program grant. The Department of Rheumatology is in receipt of infrastructure support from the Arthritis Research Campaign (grant number: 17682). Dr V Panoulas is supported by a PhD scholarship from Empirikion Institute, Athens, Greece.

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Authors and Affiliations

  1. Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Dudley, West Midlands, UK,

    V F Panoulas, K M J Douglas, M D Kita, R Klocke, G S Metsios, A Stavropoulos-Kalinoglou & G D Kitas

  2. Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece

    V F Panoulas, H J Milionis & M S Elisaf

  3. Wolfson Computer Laboratory, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK

    P Nightingale

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Correspondence to G D Kitas.

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Panoulas, V., Douglas, K., Milionis, H. et al. Serum uric acid is independently associated with hypertension in patients with rheumatoid arthritis. J Hum Hypertens 22, 177–182 (2008). https://doi.org/10.1038/sj.jhh.1002298

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