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The Role of Uric Acid in Hypertension and Heart Failure

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Hypertension and Heart Failure

Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

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Abstract

Hyperuricemia (H-SUA) is widely represented in the general population and can contribute to high blood pressure and its complications. H-SUA has also a negative prognostic effect in patients with heart failure with reduced (HFrEF) and preserved ejection fraction (HFrEF). The negative effects of H-SUA involve patients with acute and chronic HF and are not related to decline in GFR and renal disease. The negative impact of H-SUA in hypertension and HF is proportional to the levels of SUA and to xanthine oxidase (XO) activity and persists after adjustment for GFR, diuretic treatment, HF functional class, and many other confounding variables. The reduction of UA levels by XO inhibitors has resulted in promising results that warrant further investigations and a better selection of involved patients. A decrease in serum UA levels has also been recently reported in patients treated with SGLT-2 inhibitors, ARNI and Vericiguat and can contribute to the clinical benefit observed with these drugs in patients with heart failure (HFrEF and HFpEF). H-SUA should be systematically considered in patients at risk of cardiovascular disease as well as in those with HF. A decrease in serum uric acid can significantly contribute to the improvement of cardiovascular outcome observed in recent randomized clinical trials.

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy

    Claudio Borghi, Alexander Adorno, Ilaria Gallelli & Massimo Dall’Olio

  2. UOC Medicina Cardiovascolare, Ospedale S.Orsola-Malpighi, Bologna, Italy

    Claudio Borghi

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  2. Alexander Adorno
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  1. Carol Davila University of Medicine and Pharmacy, Bucharest, Bucuresti, Romania

    Maria Dorobantu

  2. Department of Pharmacology, Toxicology and Clinical Psychopharmacology Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

    Victor Voicu

  3. University of Milano-Bicocca, Milano, Italy

    Guido Grassi

  4. Dept of Clinical and Experimental Sci, University of Brescia, Brescia, Italy

    Enrico Agabiti-Rosei

  5. University of Milano-Bicocca, Milano, Italy

    Giuseppe Mancia

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Borghi, C., Adorno, A., Gallelli, I., Dall’Olio, M. (2023). The Role of Uric Acid in Hypertension and Heart Failure. In: Dorobantu, M., Voicu, V., Grassi, G., Agabiti-Rosei, E., Mancia, G. (eds) Hypertension and Heart Failure. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-031-39315-0_10

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