Asymptomatic hyperuricemia is not an independent risk factor for cardiovascular events or overall mortality in the general population of the busselton health study

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Abstract

Background: To investigate the impact of uric acid (UA) levels on cardiovascular disease and mortality at a population level. Methods: Prospective analysis of baseline serum UA measurement and 15year follow-up data from the Busselton Health Survey (n=4,173), stratified by existence or absence of baseline cardiovascular disease. Outcomes were ascertained from state-wide hospital discharge and mortality registries. Cox regression produced adjusted hazard ratios (HR) for UA level as continuous and categorical (low, medium, high) predictor for cardiovascular events (CVE) and mortality. Gout was defined as a patient's self-reported history of gout. Results: After age and gender adjustment each 0.1mmol/L rise in UA level was associated with increased mortality (HR 1.19, CI 1.04-1.36), cardiovascular mortality (HR 1.27, CI 1.03-1.57) and first CVE (HR 1.28, CI 1.13-1.44) in participants with no history of CVE. Adjustment for behavioural and biomedical risk factors of cardiovascular disease attenuated these associations. Results for participants with a history of CVE and for a subset of 1,632 participants using UA levels (2-6 measurements) averaged over time were similar. The overall prevalence of hyperuricemia was 10.7%. When stratified by history of gout, UA level was significantly associated with increased risk of cardiovascular mortality only in participants with a history of CVE (HR 2.13, CI 1.03-4.43). Conclusions: Despite the considerable prevalence of hyperuricemia in 10.7% of the population, single or time averaged measures of UA were not independently predictive of incident cardiovascular disease or mortality. Hyperuricemia did associate with an increased risk of cardiovascular death only in participants with gout and existing cardiovascular disease.

Original languageEnglish
Article number256
JournalBMC Cardiovascular Disorders
Volume16
Issue number1
DOIs
Publication statusPublished - 15 Dec 2016

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Hyperuricemia
Uric Acid
Gout
Mortality
Cardiovascular Diseases
Health
Population
State Hospitals
Hospital Mortality
Health Surveys
Registries
Serum

Cite this

@article{5bc3ed90d5714c6ba05caa6f7a40b893,
title = "Asymptomatic hyperuricemia is not an independent risk factor for cardiovascular events or overall mortality in the general population of the busselton health study",
abstract = "Background: To investigate the impact of uric acid (UA) levels on cardiovascular disease and mortality at a population level. Methods: Prospective analysis of baseline serum UA measurement and 15year follow-up data from the Busselton Health Survey (n=4,173), stratified by existence or absence of baseline cardiovascular disease. Outcomes were ascertained from state-wide hospital discharge and mortality registries. Cox regression produced adjusted hazard ratios (HR) for UA level as continuous and categorical (low, medium, high) predictor for cardiovascular events (CVE) and mortality. Gout was defined as a patient's self-reported history of gout. Results: After age and gender adjustment each 0.1mmol/L rise in UA level was associated with increased mortality (HR 1.19, CI 1.04-1.36), cardiovascular mortality (HR 1.27, CI 1.03-1.57) and first CVE (HR 1.28, CI 1.13-1.44) in participants with no history of CVE. Adjustment for behavioural and biomedical risk factors of cardiovascular disease attenuated these associations. Results for participants with a history of CVE and for a subset of 1,632 participants using UA levels (2-6 measurements) averaged over time were similar. The overall prevalence of hyperuricemia was 10.7{\%}. When stratified by history of gout, UA level was significantly associated with increased risk of cardiovascular mortality only in participants with a history of CVE (HR 2.13, CI 1.03-4.43). Conclusions: Despite the considerable prevalence of hyperuricemia in 10.7{\%} of the population, single or time averaged measures of UA were not independently predictive of incident cardiovascular disease or mortality. Hyperuricemia did associate with an increased risk of cardiovascular death only in participants with gout and existing cardiovascular disease.",
keywords = "Cardiovascular disease, Gout, Hyperuricemia, Mortality",
author = "Johannes Nossent and Warren Raymond and Mark Divitini and Matthew Knuiman",
year = "2016",
month = "12",
day = "15",
doi = "10.1186/s12872-016-0421-1",
language = "English",
volume = "16",
journal = "B M C Cardiovascular Disorders",
issn = "1471-2261",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Asymptomatic hyperuricemia is not an independent risk factor for cardiovascular events or overall mortality in the general population of the busselton health study

AU - Nossent, Johannes

AU - Raymond, Warren

AU - Divitini, Mark

AU - Knuiman, Matthew

PY - 2016/12/15

Y1 - 2016/12/15

N2 - Background: To investigate the impact of uric acid (UA) levels on cardiovascular disease and mortality at a population level. Methods: Prospective analysis of baseline serum UA measurement and 15year follow-up data from the Busselton Health Survey (n=4,173), stratified by existence or absence of baseline cardiovascular disease. Outcomes were ascertained from state-wide hospital discharge and mortality registries. Cox regression produced adjusted hazard ratios (HR) for UA level as continuous and categorical (low, medium, high) predictor for cardiovascular events (CVE) and mortality. Gout was defined as a patient's self-reported history of gout. Results: After age and gender adjustment each 0.1mmol/L rise in UA level was associated with increased mortality (HR 1.19, CI 1.04-1.36), cardiovascular mortality (HR 1.27, CI 1.03-1.57) and first CVE (HR 1.28, CI 1.13-1.44) in participants with no history of CVE. Adjustment for behavioural and biomedical risk factors of cardiovascular disease attenuated these associations. Results for participants with a history of CVE and for a subset of 1,632 participants using UA levels (2-6 measurements) averaged over time were similar. The overall prevalence of hyperuricemia was 10.7%. When stratified by history of gout, UA level was significantly associated with increased risk of cardiovascular mortality only in participants with a history of CVE (HR 2.13, CI 1.03-4.43). Conclusions: Despite the considerable prevalence of hyperuricemia in 10.7% of the population, single or time averaged measures of UA were not independently predictive of incident cardiovascular disease or mortality. Hyperuricemia did associate with an increased risk of cardiovascular death only in participants with gout and existing cardiovascular disease.

AB - Background: To investigate the impact of uric acid (UA) levels on cardiovascular disease and mortality at a population level. Methods: Prospective analysis of baseline serum UA measurement and 15year follow-up data from the Busselton Health Survey (n=4,173), stratified by existence or absence of baseline cardiovascular disease. Outcomes were ascertained from state-wide hospital discharge and mortality registries. Cox regression produced adjusted hazard ratios (HR) for UA level as continuous and categorical (low, medium, high) predictor for cardiovascular events (CVE) and mortality. Gout was defined as a patient's self-reported history of gout. Results: After age and gender adjustment each 0.1mmol/L rise in UA level was associated with increased mortality (HR 1.19, CI 1.04-1.36), cardiovascular mortality (HR 1.27, CI 1.03-1.57) and first CVE (HR 1.28, CI 1.13-1.44) in participants with no history of CVE. Adjustment for behavioural and biomedical risk factors of cardiovascular disease attenuated these associations. Results for participants with a history of CVE and for a subset of 1,632 participants using UA levels (2-6 measurements) averaged over time were similar. The overall prevalence of hyperuricemia was 10.7%. When stratified by history of gout, UA level was significantly associated with increased risk of cardiovascular mortality only in participants with a history of CVE (HR 2.13, CI 1.03-4.43). Conclusions: Despite the considerable prevalence of hyperuricemia in 10.7% of the population, single or time averaged measures of UA were not independently predictive of incident cardiovascular disease or mortality. Hyperuricemia did associate with an increased risk of cardiovascular death only in participants with gout and existing cardiovascular disease.

KW - Cardiovascular disease

KW - Gout

KW - Hyperuricemia

KW - Mortality

UR - http://www.scopus.com/inward/record.url?scp=85006127199&partnerID=8YFLogxK

U2 - 10.1186/s12872-016-0421-1

DO - 10.1186/s12872-016-0421-1

M3 - Article

VL - 16

JO - B M C Cardiovascular Disorders

JF - B M C Cardiovascular Disorders

SN - 1471-2261

IS - 1

M1 - 256

ER -