Added predictive value of high uric acid for cardiovascular events in the Ambulatory Blood Pressure International Study.
Blood Pressure Monitoring, Ambulatory
/ methods
Cardiovascular Diseases
/ diagnosis
Cohort Studies
Correlation of Data
Female
Humans
Hypertension
/ blood
International Cooperation
Male
Middle Aged
Predictive Value of Tests
Prognosis
Risk Assessment
/ methods
Risk Factors
Sex Factors
Survival Analysis
Uric Acid
/ blood
ambulatory
blood pressure
cardiovascular
hypertension
risk
uric acid
Journal
Journal of clinical hypertension (Greenwich, Conn.)
ISSN: 1751-7176
Titre abrégé: J Clin Hypertens (Greenwich)
Pays: United States
ID NLM: 100888554
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
received:
07
02
2019
revised:
26
04
2019
accepted:
09
05
2019
pubmed:
7
6
2019
medline:
8
10
2020
entrez:
7
6
2019
Statut:
ppublish
Résumé
The prognostic value of uric acid (UA) for cardiovascular events (CVE) is still debated. Our purpose was to investigate the association between UA and CVE in 5243 participants of the ABP-International study with the main aim of identifying optimal sex-specific cut-points. In multivariable Cox analyses, the relationship between CVE and UA as a continuous variable was modeled by including both linear and nonlinear terms. Survival models were also estimated with UA as a categorical variable. Optimal UA cut-points were determined using an outcome-oriented approach. During a median follow-up of 5.9 years, there were 423 CVE (93 fatal). In age- and sex-adjusted Cox models, UA as a continuous variable was a significant predictor of CVE in all individuals and in men and women considered separately. The relationship between UA and CVE was linear (P-value for nonlinearity 0.54 and 0.80 for men and women, respectively). For each 1 mg/dL increase in UA, the relative hazard increase was 16% in men and 19% in women. In fully adjusted models, UA remained a significant predictor of CVE in the whole study cohort. The optimal cut-point best separating patients at low and high risk of CVE was 6.3 mg/dL for men and 4.4 mg/dL for women. Subjects with high UA had a 38% greater risk of CVE. In a sex-specific analysis, the association remained significant only in men (hazard ratio, 1.47; P < 0.01). In conclusion, high UA is an independent predictor for subsequent CVE and significantly improves risk discrimination and reclassification over the baseline multivariable model.
Identifiants
pubmed: 31169986
doi: 10.1111/jch.13584
pmc: PMC8030500
doi:
Substances chimiques
Uric Acid
268B43MJ25
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
966-974Informations de copyright
©2019 Wiley Periodicals, Inc.
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