Effects of uric acid-lowering therapy in patients with essential arterial hypertension. Issue 3 (31st January 2022)

• Record Type: Journal Article
• Authors: Gruszka, Krystian; Drożdż, Tomasz; Wojciechowska, Wiktoria; Jankowski, Piotr; Terlecki, Michał; Bijak, Magdalena; Hering, Dagmara; Bilo, Grzegorz; Drożdż, Dorota; Rajzer, Marek
• Is Part Of: Blood pressure monitoring. Volume 27:Issue 3(2022)
• Page Start: 152
• Page End: 160
• Publication Date: 2022-01-31
• Subjects: asymptomatic hyperuricemia -- essential arterial hypertension -- hypertension-mediated organ damage -- uric acid; Blood pressure -- Measurement -- Periodicals; Blood Pressure Determination -- Periodicals; Blood Pressure Monitoring, Ambulatory -- Periodicals; Blood Pressure Monitors -- Periodicals; Hypertension -- Periodicals; 612.140287
• DOI: 10.1097/MBP.0000000000000578
• Languages: English
• ISSNs: 1359-5237

Abstract

Abstract : Objectives: Asymptomatic hyperuricemia (AHU) is elevated serum uric acid (UA) without symptoms. This study aimed to determine the effects of AHU treatment with allopurinol on selected hypertension-mediated organ damage (HMOD) indices in patients with uncomplicated essential arterial hypertension (AH). Methods: Patients aged 30–70 years with AHU and AH grade 1–2 with adequate blood pressure (BP) control, without previous urate-lowering therapy (ULT), were divided into two groups: (a) ULT (receiving allopurinol) and (b) control (age- and sex-matched patients without ULT). Both received a UA-lowering diet. BP (office, 24 h and central), echocardiographic parameters, carotid intima-media thickness (IMT) and lab tests [high-sensitivity C-reactive protein (hs-CRP)] were measured at baseline and at 6 months follow-up. Results: Of 100 participants, 87 (44 ULT, 43 controls) completed the study. At 6 months follow-up, there was a greater reduction in serum UA concentration in the ULT group than in the control group. Patients receiving allopurinol had significant reductions in office systolic and diastolic BP, central systolic BP, pulse pressure, IMT (0.773 ± 0.121 vs. 0.752 ± 0.13 mm, P = 0.044) and hs-CRP (3.36 ± 2.73 vs. 2.74 ± 1.91 mg/L, P = 0.028) compared to controls. Multivariate regression analysis revealed the independent relationship between reduction in IMT and UA lowering (P < 0.026). Conclusion: In patients with AH and AHU, treatment with allopurinol leads to improvement in BP control and reduction in HMOD intensity, in particular IMT. The decrease in hs-CRP concentration associated with ULT may have a beneficial effect on a patient's long-term prognosis.