Relationship between serum uric acid, nocturnal hypertension and risk for preeclampsia in high-risk pregnancies.


Journal

Journal of human hypertension
ISSN: 1476-5527
Titre abrégé: J Hum Hypertens
Pays: England
ID NLM: 8811625

Informations de publication

Date de publication:
23 Jul 2024
Historique:
received: 22 04 2024
accepted: 17 07 2024
revised: 10 07 2024
medline: 24 7 2024
pubmed: 24 7 2024
entrez: 23 7 2024
Statut: aheadofprint

Résumé

To analyze the possible association between serum uric acid (SUA) and nocturnal hypertension and to evaluate the ability of these variables (alone or in combination) to predict preeclampsia (PE) we conducted a historical cohort study in 532 high-risk pregnancies. Women were divided according to SUA values and nocturnal blood pressure (BP) into four groups: 1- normal SUA and nocturnal normotension; 2- high SUA and nocturnal normotension; 3- normal SUA and nocturnal hypertension and 4- high SUA and nocturnal hypertension. High SUA was defined by the top quartile values and nocturnal hypertension as BP ≥ 120/70 mmHg, using ambulatory blood pressure monitoring (ABPM), during nocturnal rest. Risks for PE were compared using logistic regression. SUA had a weak but significant correlation with daytime systolic ABPM (r = 0.11, p = 0.014), daytime diastolic ABPM (r = 0.13, p = 0.004), nighttime systolic ABPM (r = 0.16, p < 0.001) and nighttime diastolic ABPM (r = 0.18, p < 0.001). Also, all ABPM values were higher in women with high SUA. The absolute risk of PE increased through groups: 6.5%, 13.1%, 31.2%, and 47.9% for groups 1, 2, 3, and 4, respectively, p < 0.001. Compared with Group 1, Group 3 (OR 6.29 95%CI 3.41-11.60), but not Group 2 (OR 2.15 95%CI 0.88-5.24), had statistically significant higher risk for PE. Group 4 (women with both, high SUA and nocturnal hypertension) had the highest risk (OR 13.11 95%CI 6.69-25.70). Risks remained statistically significant after the adjustment for relevant variables. In conclusion, the combination of SUA > 4 mg/dL and nocturnal BP > 120/70 mmHg implies a very high risk to developed PE.

Identifiants

pubmed: 39043990
doi: 10.1038/s41371-024-00939-w
pii: 10.1038/s41371-024-00939-w
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Nature Limited.

Références

Mol BWJ, Roberts CT, Thangaratinam S, Magee LA, de Groot CJM, Hofmeyr GJ. Pre-eclampsia. Lancet. 2016;387:999–1011.
doi: 10.1016/S0140-6736(15)00070-7 pubmed: 26342729
Abalos E, Cuesta C, Grosso AL, Chou D, Say L. Global and regional estimates of preeclampsia and eclampsia: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2013;170:1–7.
doi: 10.1016/j.ejogrb.2013.05.005 pubmed: 23746796
Veisani Y, Jenabi E, Delpisheh A, Khazaei S. Angiogenic factors and the risk of preeclampsia: a systematic review and meta-analysis. Int J Reprod Biomed. 2019;17:1–10.
doi: 10.18502/ijrm.v17i1.3815 pubmed: 31435580 pmcid: 6652157
Bellos I, Papantoniou N, Pergialiotis V. Serum ceruloplasmin levels in preeclampsia: a meta-analysis. J Matern Neonatal Med. 2018;31:2342–8.
doi: 10.1080/14767058.2017.1340449
Bellos I, Karageorgiou V, Kapnias D, Karamanli K-E, Siristatidis C. The role of interleukins in preeclampsia: a comprehensive review. Am J Reprod Immunol. 2018;80:e13055.
doi: 10.1111/aji.13055 pubmed: 30265415
Tomimatsu T, Mimura K, Endo M, Kumasawa K, Kimura T. Pathophysiology of preeclampsia: an angiogenic imbalance and long-lasting systemic vascular dysfunction. Hypertens Res. 2017;40:305–10.
doi: 10.1038/hr.2016.152 pubmed: 27829661
Maiuolo J, Oppedisano F, Gratteri S, Muscoli C, Mollace V. Regulation of uric acid metabolism and excretion. Int J Cardiol. 2016;213:8–14.
doi: 10.1016/j.ijcard.2015.08.109 pubmed: 26316329
Shankar A, Klein R, Klein BEK, Nieto FJ. The association between serum uric acid level and long-term incidence of hypertension: a population-based cohort study. J Hum Hypertens. 2006;20:937–45.
doi: 10.1038/sj.jhh.1002095 pubmed: 17024135
Kuwabara M, Niwa K, Nishi Y, Mizuno A, Asano T, Masuda K, et al. Relationship between serum uric acid levels and hypertension among Japanese individuals not treated for hiperuricemia and hypertension. Hypertens Res. 2014;37:785–9.
doi: 10.1038/hr.2014.75 pubmed: 24671018
Grayson PC, Kim SY, LaValley M, Choi HK. Hyperuricemia and incident hypertension: a systematic review and meta-analysis. Arthritis Care Res. 2011;63:102–10.
doi: 10.1002/acr.20344
Cicero AFG, Salvi P, D’Addato S, Rosticci M, Borghi C. Group for the BHS. Association between serum uric acid, hypertension, vascular stiffness and subclinical atherosclerosis: data from the Brisighella Heart Study. J Hypertens. 2014;32:57–64.
doi: 10.1097/HJH.0b013e328365b916 pubmed: 24309486
Bainbridge SA, Roberts JM. Uric acid as a pathogenic factor in preeclampsia. Placenta. 2008;29:67–72.
doi: 10.1016/j.placenta.2007.11.001
Krakoff LR. Nocturnal blood pressure and cardiovascular risk. Hypertension. 2020;76:316–7.
doi: 10.1161/HYPERTENSIONAHA.120.14409 pubmed: 32639886
Yano Y, Kario K. Nocturnal blood pressure and cardiovascular disease: a review of recent advances. Hypertens Res. 2012;35:695–701.
doi: 10.1038/hr.2012.26 pubmed: 22378470
Salazar MR, Espeche WG, Leiva Sisnieguez BC, Balbín E, Leiva Sisnieguez CE, Stavile RN, et al. Significance of masked and nocturnal hypertension in normotensive women coursing a high-risk pregnancy. J Hypertens. 2016;34:2248–52.
doi: 10.1097/HJH.0000000000001067 pubmed: 27490952
Salazar MR, Espeche WG, Balbín E, Leiva Sisnieguez CE, Leiva Sisnieguez BC, Stavile RN, et al. Office blood pressure values and the necessity of out-of-office measurements in high-risk pregnancies. J Hypertens. 2019;37:1838–44.
doi: 10.1097/HJH.0000000000002140 pubmed: 31157745
Salazar MR, Espeche WG, Leiva Sisnieguez CE, Leiva Sisnieguez BC, Balbín E, Stavile RN, et al. Nocturnal hypertension in high-risk mid-pregnancies predict the development of preeclampsia/eclampsia. J Hypertens. 2019;37:182–6.
doi: 10.1097/HJH.0000000000001848 pubmed: 30015756
Bello NA, Woolley JJ, Cleary KL, Falzon L, Alpert BS, Oparil S, et al. Accuracy of blood pressure measurement devices in pregnancy: a systematic review of validation studies. Hypertension. 2018;71:326–35.
doi: 10.1161/HYPERTENSIONAHA.117.10295 pubmed: 29229741
The jamovi project (2022). jamovi. (Version 2.3) [Computer Software]. Retrieved from https://www.jamovi.org .
Abbassi-Ghanavati M, Greer LG, Cunningham FG. Pregnancy and laboratory studies: a reference table for clinicians. Obstet Gynecol. 2009;114:1326–133.
doi: 10.1097/AOG.0b013e3181c2bde8 pubmed: 19935037
Grassi G, Quarti-Trevano F, Dell’Oro R, Cuspidi C, Mancia G. The PAMELA research project: a 25-year long journey. Panminerva Medica. 2021;63:430–5.
doi: 10.23736/S0031-0808.21.04396-2 pubmed: 33878850
Bellomo G, Venanzi S, Saronio P, Verdura C, Narducci PL. Prognostic significance of serum uric acid in women with gestational hypertension. Hypertension. 2011;58:704–8.
doi: 10.1161/HYPERTENSIONAHA.111.177212 pubmed: 21876075
Johnson RJ, Kanbay M, Kang DH, Sánchez-Lozada LG, Feig D. Uric acid: a clinically useful marker to distinguish preeclampsia from gestational hypertension. Hypertension. 2011;58:548–9. https://doi.org/10.1161/HYPERTENSIONAHA.111.178921
doi: 10.1161/HYPERTENSIONAHA.111.178921 pubmed: 21876074
Lyall F, Robson SC, Bulmer JN. Spiral artery remodeling and trophoblast invasion in preeclampsia and fetal growth restriction: Relationship to clinical outcome. Hypertension. 2013;62:1046–54.
doi: 10.1161/HYPERTENSIONAHA.113.01892 pubmed: 24060885
Saito Y. The role of the PlGF/Flt-1 signaling pathway in the cardiorenal connection. J Mol Cell Cardiol. 2021;151:106–12.
doi: 10.1016/j.yjmcc.2020.10.001 pubmed: 33045252
Chen Y, Di X, Xiang G, Liu Y, Pan X, Deng W, et al. sFlt-1/PIGF ratio positive associated with non-dipper type change in ambulatory blood pressure monitoring (ABPM) for preeclampsia development. Hypertens Res. 2023. https://doi.org/10.1038/s41440-023-01509-2 .
Zeisler H, Llurba E, Chantraine F, Vatish M, Staff AC, Sennström M, et al. Predictive value of the sFlt-1:PlGF ratio in women with suspected preeclampsia. N Engl J Med. 2016;374:13–22.
doi: 10.1056/NEJMoa1414838 pubmed: 26735990
Lv LJ, Ji WJ, Wu LL, Miao J, Wen JY, Lei Q, et al. Thresholds for ambulatory blood pressure monitoring based on maternal and neonatal outcomes in late pregnancy in a southern Chinese population. J Am Heart Assoc. 2019;8:e012027.
doi: 10.1161/JAHA.119.012027 pubmed: 31267796 pmcid: 6662146
Salazar MR, Espeche WG, March CE, Marillet AG, Balbín E, Dulbecco CA, et al. Optimal uric acid threshold to identify insulin resistance in healthy women. Metab Syndr Relat Disord. 2012;10:39–46.
doi: 10.1089/met.2011.0072 pubmed: 21933003

Auteurs

Walter G Espeche (WG)

Unidad de Enfermedades Cardiometabólicas, Servicio de Clínica Médica, Hospital Gral. San Martín, La Plata, Argentina.
Facultad de Ciencias Médicas, UNLP, La Plata, Argentina.

Martin R Salazar (MR)

Unidad de Enfermedades Cardiometabólicas, Servicio de Clínica Médica, Hospital Gral. San Martín, La Plata, Argentina. mrsalazar@med.unlp.edu.ar.
Facultad de Ciencias Médicas, UNLP, La Plata, Argentina. mrsalazar@med.unlp.edu.ar.

Julián Minetto (J)

Unidad de Enfermedades Cardiometabólicas, Servicio de Clínica Médica, Hospital Gral. San Martín, La Plata, Argentina.
Facultad de Ciencias Médicas, UNLP, La Plata, Argentina.

Gustavo Cerri (G)

Unidad de Enfermedades Cardiometabólicas, Servicio de Clínica Médica, Hospital Gral. San Martín, La Plata, Argentina.

Patricia Carrera Ramos (P)

Unidad de Enfermedades Cardiometabólicas, Servicio de Clínica Médica, Hospital Gral. San Martín, La Plata, Argentina.

Adelaida Soria (A)

Servicio de Obstetricia, Hospital Gral. San Martín, La Plata, Argentina.

Claudia Santillan (C)

Servicio de Obstetricia, Hospital Gral. San Martín, La Plata, Argentina.

Florencia Grassi (F)

Servicio de Obstetricia, Hospital Gral. San Martín, La Plata, Argentina.

Soledad Torres (S)

Servicio de Obstetricia, Hospital Gral. San Martín, La Plata, Argentina.

Horacio A Carbajal (HA)

Unidad de Enfermedades Cardiometabólicas, Servicio de Clínica Médica, Hospital Gral. San Martín, La Plata, Argentina.

Classifications MeSH