Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Commentary
  • Published:

Uric acid and hypertension: an age-related relationship?

Journal of Human Hypertension volume 23, pages 75–76 (2009)Cite this article

The observation that blood pressure increases with aging was first noted by Mahomed.1 Although this has not been observed in all societies,2 in most industrialized countries hypertension increases with age and affects the majority of the population over the age of 55 years. In the United States, for example, the prevalence of hypertension rises from under 10% in individuals less than 30 years old to 65% in those between 65 and 74 years of age and to 77% of subjects over the age of 75 years.3

The pathogenesis of age-related hypertension is presumably multifactorial. One likely mechanism involves a loss of vascular compliance because of stiffening of the arteries that can manifest as isolated systolic hypertension with widened pulse pressure.4 Aging is also associated with a decrease in glomerular filtration rate (GFR) with progressive impairment in sodium excretion.5 This may relate to the development of age-related renal microvascular disease, glomerulosclerosis and capillary rarefaction.6 Experimental studies suggest that renal microvascular disease is a major mechanism for inducing salt-sensitive hypertension even in the absence of reduced GFR 7 and this could contribute to the marked increase in salt-sensitivity that is observed in aging individuals.8 Other factors are also likely involved, such as the increasing prevalence of obesity and metabolic syndrome that occurs with age.9

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Mahomed FA . On chronic Bright's disease, and its essential symptoms. Lancet 1879; i: 398–404.

    Google Scholar 

  2. Oliver WJ, Cohen EL, Neel JV . Blood pressure, sodium intake, and sodium related hormones in the Yanomamo Indians, a ‘no-salt’ culture. Circulation 1975; 52: 146–151.

    Article  CAS  Google Scholar 

  3. Fields LE, Burt VL, Cutler JA, Hughes J, Roccella EJ, Sorlie P . The burden of adult hypertension in the United States 1999–2000: a rising tide. Hypertension 2004; 44: 398–404.

    Article  CAS  Google Scholar 

  4. Franklin SS . Arterial stiffness: is it ready for prime time? Current Cardiology Reports 2007; 9: 462–469.

    Article  Google Scholar 

  5. Luft FC, Grim CE, Fineberg N, Weinberger MC . Effects of volume expansion and contraction in normotensive whites, blacks, and subjects of different ages. Circulation 1979; 59: 643–650.

    Article  CAS  Google Scholar 

  6. Thomas SE, Anderson S, Gordon KL, Oyama TT, Shankland SJ, Johnson RJ . Tubulointerstitial disease in aging: evidence for underlying peritubular capillary damage, a potential role for renal ischemia. J Am Soc Nephrol 1998; 9: 231–242.

    CAS  PubMed  Google Scholar 

  7. Johnson RJ, Feig DI, Nakagawa T, Sanchez-Lozada LG, Rodriguez-Iturbe B . Pathogenesis of essential hypertension: historical paradigms and modern insights. J Hypertens 2008; 26: 381–391.

    Article  CAS  Google Scholar 

  8. Weinberger MH, Fineberg NS . Sodium and volume sensitivity of blood pressure. Age and pressure change over time. Hypertension 1991; 18: 67–71.

    Article  CAS  Google Scholar 

  9. Ford ES . Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the US. Diabetes Care 2005; 28: 2745–2749.

    Article  Google Scholar 

  10. Jossa F, Farinaro E, Panico S, Krogh V, Celentano E, Galasso R et al. Serum uric acid and hypertension: the Olivetti heart study. J Human Hypertens 1994; 8: 677–681.

    CAS  Google Scholar 

  11. Shankar A, Klein R, Klein BE, Nieto FJ . The association between serum uric acid level and long-term incidence of hypertension: population-based cohort study. J Human Hypertens 2006; 20: 937–945.

    Article  CAS  Google Scholar 

  12. Sundstrom J, Sullivan L, D'Agostino RB, Levy D, Kannel WB, Vasan RS . Relations of serum uric acid to longitudinal blood pressure tracking and hypertension incidence. Hypertension 2005; 45: 28–33.

    Article  Google Scholar 

  13. Cannon PJ, Stason WB, Demartini FE, Sommers SC, Laragh JH . Hyperuricemia in primary and renal hypertension. N Engl J Med 1966; 275: 457–464.

    Article  CAS  Google Scholar 

  14. Sanchez-Lozada LG, Tapia E, Avila-Casado C, Soto V, Franco M, Santamaria J et al. Mild hyperuricemia induces glomerular hypertension in normal rats. Am J Physiol 2002; 283: F1105–F1110.

    Google Scholar 

  15. Feig DI, Nakagawa T, Karumanchi SA, Oliver WJ, Kang DH, Finch J et al. Hypothesis: uric acid, nephron number, and the pathogenesis of essential hypertension. Kidney Int 2004; 66: 281–287.

    Article  CAS  Google Scholar 

  16. Kanbay M, Ozkara A, Selcoki Y, Isik B, Turgut F, Bavbek N et al. Effect of treatment of hyperuricemia with allopurinol on blood pressure, creatinine clearence, and proteinuria in patients with normal renal functions. Int Urol Nephrol 2007; 39: 1227–1233.

    Article  CAS  Google Scholar 

  17. Talaat KM, El-Sheikh AR . The effect of mild hyperuricemia on urinary transforming growth factor beta and the progression of chronic kidney disease. Am J Nephrol 2007; 27: 435–440.

    Article  CAS  Google Scholar 

  18. Mazzali M, Hughes J, Kim YG, Jefferson JA, Kang DH, Gordon KL et al. Elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism. Hypertension 2001; 38: 1101–1106.

    Article  CAS  Google Scholar 

  19. Khosla UM, Zharikov S, Finch JL, Nakagawa T, Roncal C, Mu W et al. Hyperuricemia induces endothelial dysfunction. Kidney Int 2005; 67: 1739–1742.

    Article  Google Scholar 

  20. Watanabe S, Kang DH, Feng L, Nakagawa T, Kanellis J, Lan H et al. Uric acid, hominoid evolution, and the pathogenesis of salt-sensitivity. Hypertension 2002; 40: 355–360.

    Article  CAS  Google Scholar 

  21. Feig DI, Johnson RJ . Hyperuricemia in childhood primary hypertension. Hypertension 2003; 42: 247–252.

    Article  CAS  Google Scholar 

  22. Brand FN, McGee DL, Kannel WB, Stokes III J, Castelli WP . Hyperuricemia as a risk factor of coronary heart disease: the Framingham Study. Am J Epidemiology 1985; 121: 11–18.

    Article  CAS  Google Scholar 

  23. Lu Z, Dong B, Wu H, Chen T, Zhang Y, Xiao H . Serum uric acid level in primary hypertension among Chinese Nonagenarians/Centenarians. J Hum Hypertens 2008 (in press).

  24. Wang JG, Staessen JA, Fagard RH, Birkenhager WH, Gong L, Liu L . Prognostic significance of serum creatinine and uric acid in older Chinese patients with isolated systolic hypertension. Hypertension 2001; 37: 1069–1074.

    Article  CAS  Google Scholar 

  25. Casiglia E, Spolaore P, Ginocchio G, Colangeli G, Di Menza G, Marchioro M et al. Predictors of mortality in very old subjects aged 80 years or over. Eur J Epidemiol 1993; 9: 577–586.

    Article  CAS  Google Scholar 

  26. Hu P, Seeman TE, Harris TB, Reuben DB . Is serum uric acid level associated with all-cause mortality in high-functioning older persons: MacArthur studies of successful aging? J Am Geriatr Soc 2001; 49: 1679–1684.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Nephrology, Department of Medicine, Hypertension and Transplantation, University of Florida, Gainesville, FL, USA

    T Kosugi, T Nakagawa, D Kamath & R J Johnson

Authors
  1. T Kosugi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T Nakagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D Kamath
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R J Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R J Johnson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kosugi, T., Nakagawa, T., Kamath, D. et al. Uric acid and hypertension: an age-related relationship?. J Hum Hypertens 23, 75–76 (2009). https://doi.org/10.1038/jhh.2008.110

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2008.110

This article is cited by

Search

Advanced search

Quick links