PP.02.04: SERUM URIC ACID CORRELATE WITH DIPPING PATTERN IN HYPERTENSIVE PATIENTS WITHOUT HEART FAILURE. (June 2015)

• Record Type: Journal Article
• Authors: Vintila, A.; Stefan, C.; Vintila, V.; Siliste, R.; Ianula, R.; Gurghean, A.; Isacoff, D.
• Is Part Of: Journal of hypertension. Volume 33(2015)Supplement 1
• Publication Date: 2015-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000467744.11326.9f
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Current evidence supports the fact that serum uric acid could increase the risk of developing cardiovascular and renal disease in patients with arterial hypertension. On the other hand, a non-dipping blood pressure profile is associated with increased cardiovascular risk. We aimed to establish whether serum uric acid correlate with dipping pattern in hypertensive patients without heart failure. Design and method: We studied serum levels of uric acid in a cohort of hypertensive patients without heart failure, evaluated by ambulatory blood pressure monitoring (ABPM). Comorbidities (obesity, dyslipidemia, diabetes mellitus, ischemic heart disease, chronic kidney disease) were recorded and echocardiography was performed in each subject. Patients with severe chronic kidney disease (eGFR < 30 ml/min/1.73 m2) were excluded from the study. Results: The study group consisted in 50 hypertensive patients, aged 63 ± 12 years. 72% had dyslipidemia, 50% were obese, 26% had diabetes mellitus and 36% had chronic ischemic heart disease. Echocardiographic evaluation revealed left ventricular concentric remodeling, quantified by relative wall thickness (rwt) >/= 0.42, in the majority of patients (93%), irrespective of the presence or absence of comorbidities. rwt significantly correlated with E' velocity (r = - 0.614, p = 0.001), E/A ratio (r = - 0.375, p = 0.016) and left atrial transverse diameter (r = 0.363, p = 0.018). Serum uric acid correlated with dipping blood pressure profile (r = - 0.432, p = 0.008), left ventricular ejection fraction (r = - 0.379, p = 0.032) and presence of mild to moderate chronic kidney disease (r = 0.475, p = 0.003), but not with rwt. The correlation between serum uric acid and dipping blood pressure profile remained significant after adjustment for age, sex, left ventricular ejection fraction and presence or absence of chronic kidney disease. Conclusions: Patients with arterial hypertension without heart failure have prominent left ventricular concentric remodeling, which correlates with left ventricular diastolic dysfunction. Higher serum levels of uric acid correlate with non-dipper pattern of blood pressure, irrespective of the degree of left ventricular concentric remodeling or kidney dysfunction.