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.

Uric acid and the cardiovascular profile of African and Caucasian men

Abstract

The African population is considered a high-risk group for the development of hypertension, and identifying risk factors are therefore essential in preventive actions against cardiovascular disease (CVD). Elevated levels of uric acid (UA) are often associated with CVD. Our first aim was to establish possible ethnic differences in UA levels between African and Caucasian men. Our second aim was to determine any associations between UA levels and cardio-metabolic variables, and also how these correlates differ between the two groups. African (N=87) and Caucasian (N=121) men participated in this cross-sectional study. Our results have shown that African men had significantly lower (353±87.7 vs 401±98.2; P<0.01) UA levels compared with Caucasian men. Waist circumference and triglycerides correlated strongly with UA in both ethnic groups. This was confirmed with a forward stepwise multiple regression analysis. After adjustment for confounders, the correlation between UA and triglycerides remained significant only in the Caucasians (r=0.29; P=0.02), whereas only the African men showed an independent correlation between UA and total peripheral resistance (TPR) (r=0.23; P=0.04). TPR increased significantly across UA tertiles only in the African men (P=0.01 vs P=0.96). In conclusion, despite their lower UA levels, Africans showed an independent relationship between UA and vascular resistance, indicating a possible explanation for their high prevalence of hypertension.

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

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Figure 1

References

  1. Bazzano LA, He J, Whelton PK . Blood pressure in westernized and isolated populations. In: Lip G, Hall J (eds). Comprehensive Hypertension. Elsevier: New York, NY, 2007, pp 21–30.

    Chapter  Google Scholar 

  2. Ince H, Nienaber CA . Diagnosis and management of patients with aortic dissection. Heart 2007; 93: 266–270.

    Article  Google Scholar 

  3. Gagliardi ACM, Miname MH, Santos RD . Uric acid: a marker of increased cardiovascular risk. Atherosclerosis 2009; 202: 11–17.

    CAS  Article  Google Scholar 

  4. Fang J, Alderman MH . Serum uric acid and cardiovascular mortality: the NHANES I Epidemiologic Follow-up Study, 1971–1992. JAMA 2000; 283: 2404–2410.

    CAS  Article  Google Scholar 

  5. Viazzi F, Parodi D, Leoncini G, Parodi A, Falqui V, Ratto E et al. Serum uric acid and target organ damage in primary hypertension. Hypertension 2005; 45: 991–996.

    CAS  Article  Google Scholar 

  6. Mellen PB, Bleyer AJ, Erlinger TP, Evans GW, Nieto FJ, Wagenknecht LE et al. Serum uric acid predicts incident hypertension in a Biethnic cohort: the atherosclerosis risk in communities study. Hypertension 2006; 48: 1037–1042.

    CAS  Article  Google Scholar 

  7. Strasak AM, Kelleher CC, Brant LJ, Rapp K, Ruttmann E, Concin H et al. Serum uric acid is an independent predictor for all major forms of cardiovascular death in 28 613 elderly women: a prospective 21-year follow-up study. Int J Cardiol 2008; 125: 232–239.

    Article  Google Scholar 

  8. Feig DI, Kang D, Johnson RJ . Uric acid and cardiovascular risk. N Engl J Med 2008; 359: 1811–1821.

    CAS  Article  Google Scholar 

  9. Miyatake N, Kogashiwa M, Wang D, Kira S, Yamasato T, Fujii M . The relation between visceral adipose tissue accumulation and biochemical tests in university students. Acta Med Okayama 2005; 59: 129–134.

    PubMed  Google Scholar 

  10. Cohn GS, Kittleson MM, Blumenthal RS . Toward an improved diagnosis of the metabolic syndrome: other clues to the presence of insulin resistance. Am J Hypertens 2005; 18: 1099–1103.

    CAS  Article  Google Scholar 

  11. Waring WS, Esmail S . How should serum uric acid concentrations be interpreted in patients with hypertension? Curr Hypertens Rev 2005; 1: 89–95.

    CAS  Article  Google Scholar 

  12. Palmer IM, Schutte AE, Huisman HW, Van Rooyen JM, Schutte R, Malan L et al. A comparison of uric acid levels in black African vs Caucasian women from South Africa: the POWIRS study. Ethn Dis 2007; 17: 676–681.

    CAS  PubMed  Google Scholar 

  13. Conen D, Wietlisbach V, Bovet P, Shamlaye C, Riesen W, Paccaud F et al. Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country. BMC Public Health 2004; 4 (9): doi:10.1186/1471-2458-4-9.

  14. Alderman MH . Uric acid and cardiovascular risk. Curr Opin Pharmacol 2002; 2: 126–130.

    CAS  Article  Google Scholar 

  15. Sliwa K, Wilkinson D, Hansen C, Ntyintyane L, Tibazarwa K, Becker A et al. Spectrum of heart disease and risk factors in a black urban population in South Africa (the Heart of Soweto Study): a cohort study. Lancet 2008; 371: 915–922.

    Article  Google Scholar 

  16. Opie LH, Seedat YK . Hypertension in sub-Saharan African populations. Circulation 2005; 112: 3562–3568.

    Article  Google Scholar 

  17. Mack R, Skurnick B, Sterling-Jean Y, Pedra-Nobre M, Bigg D . Fasting insulin levels as a measure of insulin resistance in American blacks. J Appl Res 2004; 4: 90–94.

    CAS  Google Scholar 

  18. Norton K, Olds T (eds). Anthropometrica: A Textbook of Body Measurements for Sports and Health Courses. UNSW Press: Sydney, 1996.

    Google Scholar 

  19. Hertz RP, Unger AN, Cornell JA, Saunders E . Racial disparities in hypertension prevalence, awareness, and management. Arch Intern Med 2005; 165: 2098–2104.

    Article  Google Scholar 

  20. Reimann M, Schutte AE, Malan L, Huisman HW, Malan NT . Hyperuricaemia is an independent factor for the metabolic syndrome in a sub-Saharan African population: a factor analysis. Atherosclerosis 2008; 197: 638–645.

    CAS  Article  Google Scholar 

  21. Reimann M, Schutte AE, Schwarz PE . Insulin resistance—the role of ethnicity: evidence from Caucasian and African cohorts. Horm Metab Res 2007; 39: 853–857.

    CAS  Article  Google Scholar 

  22. Lu B, Zhou J, Waring ME, Parker DR, Eaton CB . Abdominal obesity and peripheral vascular disease in men and women: A comparison of waist-to-thigh ratio and waist circumference as measures of abdominal obesity. Atherosclerosis 2009; 208 (1): 253–257.

    Article  Google Scholar 

  23. Dagenais GR, Yi Q, Mann JFE, Bosch J, Pogue J, Yusuf S . Prognostic impact of body weight and abdominal obesity in women and men with cardiovascular disease. Am Heart J 2005; 149: 54–60.

    Article  Google Scholar 

  24. Choi HK, Liu S, Curhan G . Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: the Third National Health and Nutrition Examination Survey. Arthritis Rheum 2005; 52: 283–289.

    Article  Google Scholar 

  25. Dyer AR, Liu K, Walsh M, Kiefe C, Jacobs Jr DR, Bild DE . Ten-year incidence of elevated blood pressure and its predictors: the CARDIA study. J Hum Hypertens 1999; 13: 13–21.

    CAS  Article  Google Scholar 

  26. Johnson RJ, Segal MS, Sautin Y, Nakagawa T, Feig DI, Kang D et al. Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease. Am J Clin Nutr 2007; 86: 899–906.

    CAS  PubMed  Google Scholar 

  27. Johnson RJ, Perez-Pozo SE, Sautin YY, Manitius J, Sanchez-Lozada LG, Feig DI et al. Hypothesis: could excessive fructose intake and uric acid cause type 2 diabetes? Endocr Rev 2009; 30: 96–116.

    CAS  Article  Google Scholar 

  28. Schwarzmeier JD, Mark TL, Moser K, Lujf A . Fructose induced hyperuricemia. Res Exp Med 1974; 162: 341–346.

    CAS  Article  Google Scholar 

  29. Franklin SS . Beyond blood pressure: arterial stiffness as a new biomarker of cardiovascular disease. J Am Soc Hypertens 2008; 2: 140–151.

    Article  Google Scholar 

  30. Touyz RM . Vascular remodeling, retinal arteries, and hypertension. Hypertension 2007; 50: 603–604.

    CAS  Article  Google Scholar 

  31. Corry DB, Eslami P, Yamamoto K, Nyby MD, Makino H, Tuck ML . Uric acid stimulates vascular smooth muscle cell proliferation and oxidative stress via the vascular renin-angiotensin system. J Hypertens 2008; 26: 269–275.

    CAS  Article  Google Scholar 

  32. Kang DH, Han L, Ouyang X, Kahn AM, Kanellis J, Li P et al. Uric acid causes vascular smooth muscle cell proliferation by entering cells via a functional urate transporter. Am J Neph 2005; 25: 425–433.

    CAS  Article  Google Scholar 

  33. Kanellis J, Watanabe S, Li JH, Kang DH, Li P, Nakagawa T et al. Uric acid stimulates monocyte chemoattractant protein-1 production in vascular smooth muscle cells via mitogen-activated protein kinase and cyclooxygenase-2. Hypertension 2003; 41: 1287–1293.

    CAS  Article  Google Scholar 

  34. Zharikov S, Krotova K, Hu H, Baylis C, Johnson RJ, Block ER et al. Uric acid decreases NO production and increases arginase activity in cultured pulmonary artery endothelial cells. Am J Physiol Cell Physiol 2008; 295: C1183–C1190.

    CAS  Article  Google Scholar 

  35. Zoccali C, Maio R, Mallamaci F, Sesti G, Perticone F . Uric acid and endothelial dysfunction in essential hypertension. J Am Soc Nephrol 2006; 17: 1466–1471.

    CAS  Article  Google Scholar 

  36. Constans J, Conri C . Circulating markers of endothelial function in cardiovascular disease. Clinica Chimica Acta 2006; 368: 33–47.

    CAS  Article  Google Scholar 

  37. Lin S, Tsai D, Hsu S . Association between serum uric acid level and components of the metabolic syndrome. J Chin Med Assoc 2006; 69: 512–516.

    CAS  Article  Google Scholar 

  38. Tavil Y, Kaya MG, Oktar SÖ, Sen N, Okyay K, Yazỳcỳ HU et al. Uric acid level and its association with carotid intima–media thickness in patients with hypertension. Atherosclerosis 2008; 197: 159–163.

    CAS  Article  Google Scholar 

  39. Choi HK, Ford ES . Prevalence of the metabolic syndrome in individuals with hyperuricemia. Am J Med 2007; 120: 442–447.

    Article  Google Scholar 

Download references

Acknowledgements

We are grateful for those funding this project, namely the Southern African National Research foundation (NRF GUN number 2073040), Medical Research Council and Africa Unit for Transdisciplinary Health Research (AUTHeR) from the Northwest University. We also thank the participants of this study, the supporting staff and colleagues of the Hypertension in Africa Research Team (HART) from the Northwest University, as well as Mrs C Lessing. This study was supported by grants from Southern African National Research Foundation (GUN 2073040), Medical Research Council and Africa Unit for Transdisciplinary Health Research.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A E Schutte.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Palmer, I., Schutte, A. & Huisman, H. Uric acid and the cardiovascular profile of African and Caucasian men. J Hum Hypertens 24, 639–645 (2010). https://doi.org/10.1038/jhh.2010.1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2010.1

Keywords

  • uric acid
  • cardiovascular disease
  • metabolic syndrome
  • African population
  • Caucasian population

Further reading

Search

Quick links