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Hyperuricemia and Risk of Cardiovascular Outcomes: The Experience of the URRAH (Uric Acid Right for Heart Health) Project

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Abstract

The latest European Guidelines of Arterial Hypertension have officially introduced uric acid evaluation among the cardiovascular risk factors that should be evaluated in order to stratify patient’s risk. In fact, it has been extensively evaluated and demonstrated to be an independent predictor not only of all-cause and cardiovascular mortality, but also of myocardial infraction, stroke and heart failure. Despite the large number of studies on this topic, an important open question that still need to be answered is the identification of a cardiovascular uric acid cut-off value. The actual hyperuricemia cut-off (> 6 mg/dL in women and 7 mg/dL in men) is principally based on the saturation point of uric acid but previous evidence suggests that the negative impact of cardiovascular system could occur also at lower levels. In this context, the Working Group on uric acid and CV risk of the Italian Society of Hypertension has designed the Uric acid Right for heArt Health project. The primary objective of this project is to define the level of uricemia above which the independent risk of CV disease may increase in a significantly manner. In this review we will summarize the first results obtained and describe the further planned analysis.

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Acknowledgements

URRAH Project participating centres and investigators: Dipartimento di Scienze Mediche e Chirurgiche Alma Mater Studiorum, Università di Bologna. Claudio Borghi (coordinator), Arrigo F.G. Cicero. Dipartimento di Scienze Cliniche e Sperimentali, Università di Brescia. Maria Lorenza Muiesan (coordinator), Enrico Agabiti Rosei, Massimo Salvetti. Dipartimento di Geriatria e Terapia Intensiva Geriatrica, Università di Firenze, Azienda Ospedaliero Universitaria Careggi, Firenze. Andrea Ungar (coordinator), Giulia Rivasi. Dipartimento di Medicina Interna e Specialità Mediche, Università degli Studi di Genova e Policlinico Universitario San Martino-IST Genova. Roberto Pontremoli (coordinator), Francesca Viazzi. Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell’Ambiente, Università degli Studi dell’Aquila. Giovambattista Desideri. Dipartimento di Scienze della Salute, Università di Milano-Bicocca, Ospedale S Gerardo dei Tintori, Monza (MB). Guido Grassi (coordinator), Michele Bombelli, Rita Facchetti. Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell’Ambiente, Università degli Studi dell’Aquila. Claudio Ferri (coordinator), Bruno Bernardino. Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli “Federico II”. Ferruccio Galletti (coordinator), Lanfranco D’Elia. Dipartimento di Medicina, Università di Padova. Paolo Palatini. Dipartimento di Medicina, Università di Padova. Edoardo Casiglia (coordinator), Valerie Tikhonoff. Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo. Carlo M. Barbagallo. Dipartimento di Medicina, Ospedale di Assisi (PG). Paolo Verdecchia. Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa. Agostino Virdis (coordinator), Stefano Masi. Azienda Ospedaliera “Bianchi-Melacrino-Morelli” & CNR-IFC, Reggio Calabria. Francesca Mallamaci. Dipartimento di Scuola medica Salernirtana, Università di Salerno. Massimo Cirillo. Dipartimento di Medicina, Ospedale Ca’ Foncello, Azienda ULSS 2 Marca Trevigiana, Treviso. Marcello Rattazzi (coordinator), Paolo Pauletto. Dipartimento di Emergenza e Trapianto d’Organo, Azienda Ospedaliero-Universitaria Consorziale Policlinico, Università “Aldo Moro”, Bari. Pietro Cirillo (coordinator), Loreto Gesualdo. Ospedale Santa Maria della Misericordia, Rovigo. Alberto Mazza. Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milano. Cristina Giannattasio (coordinator), Alessandro Maloberti. Dipartimento di Medicina Clinica e Molecolare, Università di Roma Sapienza, Ospedale S Andrea, Roma. Massimo Volpe (coordinator), Giuliano Tocci. Dipartimento di Medicina Interna, Chirurgia e Odontoiatria, Scuola Medica Salernitana, Università di Salerno. Guido Iaccarino. Dipartimento di Neuroscienze ed Organi di Senso, Università degli Studi di Bari. Pietro Nazzaro.

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Authors and Affiliations

  1. Cardiology IV, “A.De Gasperis” Department, Ospedale Niguarda Ca’ Granda, Piazza Ospedale Maggiore 3, 20159, Milan, Italy

    Alessandro Maloberti & C. Giannattasio

  2. Health Science Department, Milano-Bicocca University, Milan, Italy

    Alessandro Maloberti, C. Giannattasio, M. Bombelli, R. Facchetti, G. Parati, R. Dell’Oro, F. Quarti-Trevano & G. Grassi

  3. Clinica Medica, San Gerardo Hospital, Monza, Italy

    M. Bombelli, R. Dell’Oro, F. Quarti-Trevano & G. Grassi

  4. Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy

    G. Desideri, C. Ferri & B. Bernardino

  5. Department of Medical and Surgical Science, Alma Mater Studiorum University of Bologna, Bologna, Italy

    A. F. G. Cicero & C. Borghi

  6. Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy

    M. L. Muiesan, E. A. Rosei & M. Salvetti

  7. Department of Geriatric and Intensive Care Medicine, Careggi Hospital and University of Florence, Florence, Italy

    A. Ungar & G. Rivasi

  8. Department of Internal Medicine, University of Genoa and Policlinico SanMartino, Genoa, Italy

    R. Pontremoli & F. Viazzi

  9. Department of Clinical Medicine and Surgery, “Federico II” University of Naples Medical School, Naples, Italy

    F. Galletti & L. D’Elia

  10. Studium Patavinum, Department of Medicine, University of Padua, Padua, Italy

    P. Palatini & E. Casiglia

  11. Department of Medicine, University of Padua, Padua, Italy

    V. Tikhonoff & M. Rattazzi

  12. Biomedical Department of Internal Medicine and Specialistics, University of Palermo, Palermo, Italy

    C. M. Barbagallo

  13. Hospital S. Maria della Misericordia, Perugia, Italy

    P. Verdecchia

  14. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

    S. Masi & A. Virdis

  15. Reggio Cal Unit, CNR-IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Calabria, Italy

    F. Mallamaci

  16. Department of Public Health, “Federico II” University of Naples, Naples, Italy

    M. Cirillo

  17. Medicina Interna I, Ca’ Foncello University Hospital, Treviso, Italy

    M. Rattazzi & P. Pauletto

  18. Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, “Aldo Moro” University of Bari, Bari, Italy

    P. Cirillo & L. Gesualdo

  19. Department of Internal Medicine, Santa Maria della Misericordia General Hospital, AULSS 5 Polesana, Rovigo, Italy

    A. Mazza

  20. Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant’Andrea Hospital, Rome, Italy

    M. Volpe & G. Tocci

  21. IRCCS Neuromed, Pozzilli, Italy

    M. Volpe & G. Tocci

  22. Department of Advanced Biomedical Sciences, “Federico II” University of Naples, Naples, Italy

    G. Iaccarino

  23. Department of Medical Basic Sciences, Neurosciences and Sense Organs, University of Bari Medical School, Bari, Italy

    P. Nazzaro

  24. Italian Society of General Medicine (SIMG), Avezzano, L’Aquila, Italy

    L. Lippa

  25. Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan, Italy

    G. Parati

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  1. Alessandro Maloberti
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  2. C. Giannattasio
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  3. M. Bombelli
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  4. G. Desideri
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  6. M. L. Muiesan
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  7. E. A. Rosei
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  8. M. Salvetti
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  9. A. Ungar
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  10. G. Rivasi
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  11. R. Pontremoli
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  13. R. Facchetti
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  14. C. Ferri
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  15. B. Bernardino
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  16. F. Galletti
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  17. L. D’Elia
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  18. P. Palatini
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  19. E. Casiglia
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  20. V. Tikhonoff
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  21. C. M. Barbagallo
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  22. P. Verdecchia
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  23. S. Masi
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  24. F. Mallamaci
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  25. M. Cirillo
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  26. M. Rattazzi
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  27. P. Pauletto
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  28. P. Cirillo
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  29. L. Gesualdo
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  30. A. Mazza
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  31. M. Volpe
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  32. G. Tocci
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  33. G. Iaccarino
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  34. P. Nazzaro
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  35. L. Lippa
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  36. G. Parati
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  37. R. Dell’Oro
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  38. F. Quarti-Trevano
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  39. G. Grassi
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  40. A. Virdis
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  41. C. Borghi
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Consortia

Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension (SIIA)

Corresponding author

Correspondence to Alessandro Maloberti.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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All the authors declares that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Maloberti, A., Giannattasio, C., Bombelli, M. et al. Hyperuricemia and Risk of Cardiovascular Outcomes: The Experience of the URRAH (Uric Acid Right for Heart Health) Project. High Blood Press Cardiovasc Prev 27, 121–128 (2020). https://doi.org/10.1007/s40292-020-00368-z

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  • DOI: https://doi.org/10.1007/s40292-020-00368-z

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