高尿酸血症与高血压

正高尿酸血症作为一种代谢疾病,其患病率逐年增加。血清尿酸水平升高与冠心病、高血压等心血管病密切相关。因此,详实了解高尿酸血症与高血压之间的相互关系,对于我国人群慢性疾病的防治意义重大。1尿酸与原发性高血压的关系流行病研究显示,高血压患者中高尿酸血症的患病率在20%~40%之间,而痛风患者中高血压的患病率在25%~50%之间。在动物实验中,大鼠形成轻度的高尿酸血症后出现了高血压,而对高尿酸血症的干预又可防止高血压的形成。在     

高尿酸血症与心血管病

近年来,高尿酸血症(Hyperuricemia,HUA)的发病率逐渐升高。由于HUA与传统的危险因素如高血压、血脂异常、糖尿病、肥胖等以及冠心病(CHD)、脑卒中、心力衰竭等心血管病(CVD)相关联,因此它与CVD的关系、在CVD发病机制中可能的作用越来越引起人们的关注。由于临床上有安全可靠的降低血尿酸(UA)水平的药物,因此确定HUA与CVD的关系及降低血UA水平是否有益于CVD预后尤为重要。1血UA的生成与排泄HUA国外定义为男性≥416μmol/L,女性≥360μmol/L〔1〕。国内目前尚无统一诊断标准,多参照国外标准或略有降低(男性≥390μmol/L,女性…     

高尿酸血症与高血压的关系

近年来,随着营养条件改善,人类的平均寿命延长,高尿酸血症的发病率日趋升高,本文就高尿酸血症引起高血压的发病机理及治疗作一综述.     

高尿酸血症与高血压的关系

近年来,随着营养条件改善,人类的平均寿命处长,高尿酸血症的发病率日趋升高,本文就高尿酸血症引起高血压的发病机理及治疗作一综述。     

老年人高尿酸血症与高血压相关性研究

采取整群抽样方法抽取社区居民6 278例,分别测其血压及血尿酸值.根据血尿酸水平分为高尿酸血症组与血尿酸正常组.发现高尿酸血症组高血压患病率明显高于血尿酸正常组,两组间静息收缩压、舒张压及脉压水平均有显著性差异.认为高尿酸血症与高血压有明确的相关性,是其独立的致病因素.     

高尿酸血症与高血压的关系研究

目的探讨高血压患者血清尿酸与高血压的关系及临床价值。方法比较高血压组100例患者和正常血压组100例之间的血尿酸水平,分析高尿酸血症与高血压之间的关系。结果高血压组血尿酸为(471.66±36.47)μmol/L,正常血压组血尿酸为(267±13.11)μmol/L,差异有统计学意义(P0.01)。血尿酸水平随着高血压的分级程度及危险性增大而增加。结论血尿酸水平与高血压病关系密切,高尿酸血症可能是高血压病独立危险因素,是导致心、脑、肾损害的重要因素之一。     

高血压伴高尿酸血症患者的临床特征

目前认为高尿酸血症是动脉硬化形成的一个危险因素.我们观察高血压伴高尿酸血症患者血糖、血脂代谢及心脏结构的变化,了解其内在关系。     

高尿酸血症与心血管疾病

高尿酸血症与心血管疾病,尤其是与冠心病的关系,多年来一直存在争论。本文就近年有关文献作一综述。１高尿酸血症的生理与病理生理尿酸是核酸代谢的产物,尿酸在血中溶解饱和度有限,最大溶解饱和度为４１６μｍｏｌ／Ｌ,超过此浓度即会出现结晶,沉积下来,男性超过３...     

高尿酸血症与高血压关系的临床与用药

全世界有超过25％的人患有原发性高血压，遗传学、生理学及流行病学研究为原发性高血压的病因提供了一些线索，但尚未形成一个明确的观点。许多证据和Guyton的假说都表明，在相同的血压水平下，高血压病患者存在肾脏排泌功能的生理缺陷。最近的实验和临床研究表明尿酸与原发性高血压的发病有关。     

无症状高尿酸血症对老年高血压患者全因死亡及心血管事件的影响

目的探讨无症状高尿酸血症对老年高血压患者全因死亡及心血管事件的影响。方法选择2010年10月~2014年6月解放军总医院第二医学中心就诊的老年高血压患者743例,根据诊断分为无症状高尿酸血症组122例和非高尿酸血症组621例。采用Cox比例风险回归模型分析无症状高尿酸血症与全因死亡及心血管事件的关系。结果无症状高尿酸血症组年龄、冠心病和血尿酸水平明显高于非高尿酸血症组,舒张压水平明显低于非高尿酸血症组,差异有统计学意义(P<0.05,P<0.01)。无症状高尿酸血症组全因死亡的累积发生率明显高于非高尿酸血症组(41.6%vs 33.7%,P=0.000)。多因素Cox比例风险回归模型分析中,无症状高尿酸血症组全因死亡、非致死性心肌梗死分别是非高尿酸血症组的1.570倍(95%CI:1.062~2.322,P=0.024)、2.278倍(95%CI:2.278~4.902,P=0.035)。结论无症状高尿酸血症是心血管疾病的危险因素,导致老年高血压患者全因死亡及非致死性心肌梗死发生率显著增加。     

原发性高血压合并高尿酸血症患者血清胰岛素水平和胰岛素抵抗的相关研究

目的 :旨在观察原发性高血压合并高尿酸血症、与不合并高尿酸血症患者胰岛素抵抗和空腹血清胰岛素水平的差异。方法 :将 2 2 6例原发性高血压患者分为高血压合并高尿酸血症患者 (HU )组 163例 ,原发性高血压不合并高尿酸血症患者 (H )组 63例 ,检测空腹血清胰岛素和血清尿酸、血脂等。结果 :血清尿酸、血糖、血总胆固醇和低密度脂蛋白胆固醇、心率以及空腹血清胰岛素和HOMA指数在HU组均较H组增高 ,有显著性差异 (P <0 0 5或P <0 0 1)。在控制了性别和年龄之后 ,HU组的HOMA指数与血清尿酸、收缩压、舒张压和臀围呈正相关 ;血清胰岛素与血尿酸、收缩压和舒张压呈正相关 ;血清尿酸与心率呈正相关 (P <0 0 5或P <0 0 1)。在HU组中作多元线性回归分析表明 :HOMA指数、性别及心率进入以血清尿酸为因变量的回归方程。结论 :原发性高血压合并高尿酸血症患者空腹血清胰岛素和HOMA胰岛素抵抗指数较原发性高血压不合并高尿酸血症患者显著增高 ,并与高血压和高尿酸血症密切相关。     

H型高血压研究进展

H型高血压是伴有血浆同型半胱氨酸升高的原发性高血压,约占我国成年人高血压的75％,与脑卒中及其他心血管疾病密切相关。降低高血压患者同型半胱氨酸水平对预防卒中有重要意义。     

主动脉夹层与高尿酸血症相关性研究

目的应用病例对照研究方法探讨主动脉夹层与高尿酸血症的相关性,进一步从临床生化角度探讨主动脉夹层形成的可能原因,并提出防治措施。方法选取经增强CT或MRI确诊为主动脉夹层患者179例作为病例组,对照组为同一医院同期相同年龄段住院的非主动脉夹层患者183例。收集患者的一般资料及血尿酸指标,采用相关危险因子及t检验、χ2检验研究其相关性。结果血尿酸与主动脉夹层的联系强度高〔OR=3.26,95%CI(2.01,4.78)〕,说明高尿酸血症者发生主动脉夹层的危险性是血尿酸正常者的3.26倍。结论高尿酸血症是主动脉夹层的危险因子,两者存在明显的相关性。     

高血压病合并高尿酸血症与冠心病的关系

目的 探讨高血压病合并高尿酸血症在冠心病患病风险及冠状动脉病变程度评估中的价值.方法 选取临床疑诊冠心病的患者662例,根据高血压病与高尿酸血症的发病情况分为高血压病合并高尿酸血症组、单纯高血压痛组、单纯高尿酸血症组、无高血压病及高尿酸血症组.所有患者行冠状动脉造影并依据冠状动脉病变程度分为冠心病组和非冠心痛组,对冠状动脉病变程度的评估应用Gensini评分方法,观察高血压痛合并高尿酸血症与冠心病的关系.结果 冠心病组患者血尿酸水平(358.1±95.1 μmol/L)、高尿酸血症(30.8%)及高血压病(52.6%)患病率高于非冠心痛组(P＜0.05).高血压病、高尿酸血症是冠心病患病有意义的预测因子,二者存在交互作用,OR为1.17.高尿酸血症合并高血压病的冠心痛患者Gensini评分显著升高.高血压痛合并高尿酸血症的患病率与冠状动脉病变血管支数存在趋势性关系.结论 联合应用血尿酸与高血压痛对冠状动脉病变程度及患病风险评估可能有一定临床意义.     

高血压合并高尿酸血症患者血清瘦素和胰岛素抵抗的相关研究

目的:本研究旨在观察空腹血清瘦素(FL)和胰岛素(FI)在高血压合并高尿酸血症患者的表达以及与无高尿酸血症的高血压患者和正常对照者的差异。方法:高血压合并高尿酸血症患者组163例,不伴高尿酸血症的高血压患者组63例,正常对照组28例。停止抗高血压药物2周及禁止高嘌呤饮食48小时后取空腹静脉血,检测血尿酸、血脂等。放免法检测FL和FI。结果:在高血压合并高尿酸血症组,FL、FI和HOMA指数(HOMA-IR)较不伴高尿酸血症的高血压组和正常对照组显著增高(P<0.01或P<0.05)。在不伴高尿酸血症的高血压组,仅FL以及HOMAIR较正常对照组增高(P均<0.05),而FI在两组间差异无显著。在控制了性别和年龄之后,在高血压合并高尿酸血症组,FL与血尿酸、体重指数、FI、HOMAIR、收缩压、腰围和心率成正相关(P<0.01)。HOMAIR与血尿酸、收缩压、舒张压和臀围成正相关(P<0.01或P<0.05),FI与血尿酸、收缩压和舒张压成正相关(P<0.01或P<0.05)。在高血压合并高尿酸血症组中作多元线形回归分析表明:血尿酸、体重指数、高密度脂蛋白胆固醇、HOMAIR、性别和心率进入以FL为因变量的回归方程。结论:高血压合并高尿酸血症组血中FL、FI和HOMAIR较不伴高尿酸血症的高血压患者组和对照组显著增高,表明高血压合并高尿酸血症患者中可能同时存在着异常的FL和FI以及胰岛素抵抗。     

Age and sex dependent association of uric acid and incident hypertension

Background and aimsA previous meta-analysis suggested that the relationship between hyperuricemia and hypertension may be stronger in younger individuals and women. We aimed to investigate the age and sex dependent association of uric acid (UA) and incident hypertension.Methods and resultsWe analyzed data from the Health Examinees Study, a community-based prospective cohort study conducted in Korea from 2004 to 2013. It included 29,088 non-hypertensive subjects aged 40–79 (age, 52.5 ± 7.8 years; men, 31.4%) who had serum UA measurement and participated in the follow-up survey. The risk factors of hypertension were assessed using Cox regression. Over a mean 3.8 years of follow-up, 1388 men (15.2%) and 1942 women (9.7%) were newly diagnosed with hypertension. Upon age- and sex-based stratification, the risk of hypertension was highest in hyperuricemic subjects aged 40–49 years (HR: women, 2.16; men, 1.30). Across the entire cohort, the risk of incident hypertension was higher in groups with higher serum UA levels, and highest in women aged 40–49 years (HR, 1.44; P < 0.001). On multivariable linear regression analysis, the higher the baseline serum UA level, the greater the increase in blood pressure during follow-up, and this effect was strongest in women aged 40–49 years (β = 0.87 and P < 0.01 for systolic blood pressure).ConclusionsThe relationship between uric acid and incident hypertension tended to be dependent on age and sex. Younger women are at highest risk of UA-related incident hypertension.     

Hyperuricemia and its association with carotid intima-media thickness in hypertensive and non hypertensive patients

Carotid intima-media thickness (C-IMT) measured noninvasively by ultrasonography is widely used as a marker for increased risk of cardiovascular disease. Also hyperuricemia (HU) is a well recognized risk factor for cardiovascular diseases. The study was designed to assess the relation between hyperuricemia and carotid intima-media thickness C-IMT in patients with and without hypertension (HTN).This study included 126 patients divided into four groups: (1) Group A, included 59 hypertensive patients with hyperuricemia. (2) Group B, included 29 hypertensive patients without hyperuricemia. (3) Group C, included 17 patients with hyperuricemia and normal blood pressure without history of hypertension. (4) Group D, included 21 control subjects.We measured carotid intima-media thickness by B-mode ultrasound in the common carotid and internal carotid artery. Routine echocardiography and uric acid level was assessed for all patients.We found that C-IMT was significantly higher in group A, B and C than group D; and it was significantly higher in group A than B. This means that C-IMT is significantly higher in all hypertensive groups than control group but it was significantly higher in hypertensive hyperuricemia (group A) than those hypertensives without hyperuricemia. We also observed a higher C-IMT in hyperuricemic non hypertensive patients than control group this means that hyperuricemia per se could be a risk factor for atherosclerosis.Uric acid levels among the whole number of patients included in the study and among the groups with hyperuricemia (group A and C) were positively correlated with the intimal-media thickness (IMT) while there were no correlations in the other two groups without hyperuricemia.We found that left ventricular hypertrophy (LVH) was significantly higher in hypertensive patients (group A&B) than normotensives (group C&D) either with or without hyperuricemia and this was evident in the hypertensive hyperuricemic patients (group A); but unexpectedly we observed the presence of LVH in the hyperuricemic non hypertensive patients (group C) which was significantly higher than the control group (group D). This means that hyperuricemia is a risk factor for development of LVH hypertrophy independently of hypertension.Therefore, higher serum uric acid levels are associated with increased C-IMT and left ventricular hypertrophy in hypertensive and even non hypertensive patients. So, early screening for hyperuricemia and lowering serum uric acid levels might be beneficial in slowing progression of atherogenesis.     

高尿酸血症对大鼠血压和血清脂联素的影响

目的观察高尿酸血症对大鼠血压和血清脂联素的影响,探讨高尿酸血症导致的血清脂联素的变化与血管内皮功能的关系。方法 36只雄性SD大鼠随机分为3组。使用高酵母膏饲料联合氧嗪酸钾悬液腹腔注射6周诱导大鼠高尿酸血症(n=12)。别嘌醇组(n=12)在给予酵母提取物和氧嗪酸钾同时给予别嘌醇灌胃。普通饲料饲养的大鼠作为对照(n=12)。测量大鼠收缩压。6周后处死大鼠,全自动生化分析仪检测血清尿酸,ELISA法检测血清脂联素、一氧化氮和内皮素1,免疫组织化学法检测大鼠主动脉内膜层内皮型一氧化氮合酶的表达量。结果与正常对照组相比,模型组大鼠血尿酸、内皮素1、收缩压显著升高,血清脂联素、一氧化氮及主动内膜层内皮型一氧化氮合酶表达量显著降低。与模型组相比,别嘌醇组血尿酸、内皮素1、收缩压降低,血清脂联素和一氧化氮水平升高,主动脉内膜内皮型一氧化氮合酶表达增加。脂联素与血尿酸、内皮素1、收缩压呈负相关。结论高尿酸血症诱导的大鼠高血压与血清脂联素、一氧化氮的降低及内皮素的升高有关。