TY - JOUR
T1 - Elevated uric acid and obesity-related cardiovascular disease risk factors among hypertensive youth
AU - Reschke, Lauren D.
AU - Miller, Edgar R.
AU - Fadrowski, Jeffrey J.
AU - Loeffler, Lauren F.
AU - Holmes, Kathryn W.
AU - Appel, Lawrence J.
AU - Brady, Tammy M.
N1 - Publisher Copyright:
© 2015, IPNA.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background: Uric acid (UA) is associated with high blood pressure in adolescents and with left ventricular hypertrophy (LVH) and cardiovascular disease (CVD) in adults. We sought to determine if UA is independently associated with CVD risk factors and left ventricular mass (LVM) over time in hypertensive youth. Methods: This was a 1-year prospective observational study of hypertensive children aged 3–19 years. Cross-sectional and longitudinal associations of serum UA with CVD risk factors and LVM were explored. Results: Of the 49 children who completed both the baseline and 12-month assessments, at baseline the mean age was 13.8 years and mean UA was 5.5 mg/dL; 24 % had elevated UA, 51 % were overweight/obese and 39 % had LVH. Measures of adiposity, low high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, LVM and LVH were all significantly associated with elevated UA at baseline, but not with change over time. Each 1 mg/dL increase in baseline UA was associated with a 2.5 g/m2.7 increase in the LVM index at follow-up (95 % confidence interval 0.64, 4.39; p = 0.01); after adjustment for age, sex, race, body mass index z-score, change in UA, time, blood pressure and medication use, this association was no longer significant. Conclusions: Hypertensive children with elevated UA have a higher prevalence of obesity-related CVD risk factors. Among hypertensive children, UA may be a marker of adiposity and not an independent CVD risk factor.
AB - Background: Uric acid (UA) is associated with high blood pressure in adolescents and with left ventricular hypertrophy (LVH) and cardiovascular disease (CVD) in adults. We sought to determine if UA is independently associated with CVD risk factors and left ventricular mass (LVM) over time in hypertensive youth. Methods: This was a 1-year prospective observational study of hypertensive children aged 3–19 years. Cross-sectional and longitudinal associations of serum UA with CVD risk factors and LVM were explored. Results: Of the 49 children who completed both the baseline and 12-month assessments, at baseline the mean age was 13.8 years and mean UA was 5.5 mg/dL; 24 % had elevated UA, 51 % were overweight/obese and 39 % had LVH. Measures of adiposity, low high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, LVM and LVH were all significantly associated with elevated UA at baseline, but not with change over time. Each 1 mg/dL increase in baseline UA was associated with a 2.5 g/m2.7 increase in the LVM index at follow-up (95 % confidence interval 0.64, 4.39; p = 0.01); after adjustment for age, sex, race, body mass index z-score, change in UA, time, blood pressure and medication use, this association was no longer significant. Conclusions: Hypertensive children with elevated UA have a higher prevalence of obesity-related CVD risk factors. Among hypertensive children, UA may be a marker of adiposity and not an independent CVD risk factor.
KW - Blood pressure
KW - Cardiovascular disease
KW - Children
KW - Left ventricular hypertrophy
KW - Longitudinal
KW - Obesity
KW - Uric acid
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U2 - 10.1007/s00467-015-3154-y
DO - 10.1007/s00467-015-3154-y
M3 - Article
C2 - 26135139
AN - SCOPUS:84945456300
SN - 0931-041X
VL - 30
SP - 2169
EP - 2176
JO - Pediatric Nephrology
JF - Pediatric Nephrology
IS - 12
ER -