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Baseline and change in serum uric acid predict the progression from prehypertension to hypertension: a prospective cohort study

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Abstract

Evidence is lacking about the role of serum uric acid (SUA) in the progression from prehypertension to hypertension. Herein, we aimed to investigate the association of both baseline and dynamic change in SUA with the risk of hypertension developing from prehypertension. The study enrolled 11,488 participants with prehypertension during 2006–2010 from the Kailuan study. Change in SUA was assessed as % change of SUA from 2006 (baseline) to 2010. Participants were categorized into four groups by quartiles of baseline and change in SUA, separately. Multivariable logistic regressions were used to calculation the odds ratio (OR) and 95% confidence interval (CI). During a median follow-up of 7.06 years, 2716 (23.64%) participants developed hypertension from prehypertension. In the multivariable-adjusted model, the OR for hypertension comparing participants in the highest versus the lowest quartile of baseline SUA were 1.18 (95% CI, 1.02–1.36). Increased SUA over time was also associated with elevated risk of hypertension (OR in the highest quartile was 1.41 [95% CI, 1.23–1.62] versus the lowest quartile), especially in those with baseline SUA ≥ median (OR, 1.48; 95% CI, 1.21–1.81). Moreover, the addition of SUA to a conventional risk model had an incremental effect on the predictive value for hypertension (integrated discrimination improvement 0.30%, P < 0.0001; category-free net reclassification improvement 12.36%, P < 0.0001). Both high initial SUA and increased SUA over time can independently predict the progression from prehypertension to hypertension. Strategies aiming at controlling SUA level in prehypertensive subjects may impede the onset of hypertension.

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Fig. 1
Fig. 2: Combined effect of baseline and change in SUA on the risk of hypertension from prehypertension.
Fig. 3

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Data are available to researchers on request for purposes of reproducing the results or replicating the procedure by directly contacting the corresponding author.

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Code are available to researchers on request for purposes of reproducing the results or replicating the procedure by directly contacting the corresponding author.

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Acknowledgements

We thank all study participants, their relatives, the members of the survey teams at the 11 regional hospitals of the Kailuan Medical Group; and the project development and management teams at the Beijing Tiantan Hospital and the Kailuan Group.

Funding

This work was supported by the National Natural Science Foundation of China (grant number 81773512), Beijing Municipal Administration of Hospitals Incubating Program (PX2020021), Beijing Excellent Talents Training Program (2018000021469G234), Young Elite Scientists Sponsorship Program by CAST (2018QNRC001), and National Key Research and Development Program of China (No. 2018YFC1312800 and 2018YFC1312801).

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Author notes

  1. These authors contributed equally: Xue Tian, Anxin Wang

Authors and Affiliations

  1. Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China

    Xue Tian, Yingting Zuo, Licheng Zhang & Yanxia Luo

  2. Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China

    Xue Tian, Yingting Zuo, Licheng Zhang & Yanxia Luo

  3. China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Anxin Wang

  4. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Anxin Wang

  5. Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China

    Shuohua Chen & Shouling Wu

  6. Department of Neurological Intervention, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Dapeng Mo

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  1. Xue Tian
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Tian, X., Wang, A., Zuo, Y. et al. Baseline and change in serum uric acid predict the progression from prehypertension to hypertension: a prospective cohort study. J Hum Hypertens 36, 381–389 (2022). https://doi.org/10.1038/s41371-021-00522-7

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