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Association of serum uric acid with the risk of developing hypertension: A prospective cohort study with mediation analysis

Hypertension Research volume 46, pages 345–356 (2023)Cite this article

Abstract

Elevated serum uric acid (SUA) is associated with the incidence of hypertension, but whether relevant metabolic factors have mediating effects is not certain. Our study was based on a functional community cohort established in Beijing. In 2015, a total of 7482 individuals without hypertension were recruited and followed up until 2019. Multivariate logistic regression analysis was used to investigate the association between SUA and hypertension. Cross-lagged panel analysis and mediation analysis were used to explore the effects of metabolic factors on the association between SUA and incident hypertension. During the average 4-year follow-up, the cumulative incidence of hypertension was 10.9% (n = 580). SUA was an independent risk factor for hypertension, and the RRs (95% CI) for subjects with baseline SUA levels in quartile 2, quartile 3 and quartile 4 were 1.20 (0.88–1.63), 1.50 (1.10–2.05), and 1.57 (1.11–2.22) compared to those in quartile 1, respectively. The cross-lagged panel analysis showed that the increases in Cr, TG, LDL, ALT, AST and WBC occurred after SUA increased (P < 0.001). Among these factors, TG, WBC and ALT played an intermediary role in both men (TG: 14.76%; WBC: 11.61%; ALT: 15.93%) and women (TG: 14.55%; WBC: 8.55%; ALT: 6.89%). The elevated SUA concentration was an independent risk factor for hypertension in the Chinese population, and TG, WBC and ALT had important mediating effects on the association between SUA and hypertension.

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Acknowledgements

The authors thank Xuanwu Hospital of Capital Medical University for their support and assistance in this study. The authors thank the National Natural Science Foundation of China.

Funding

This work was supported by grants from the National Natural Science Foundation of China (81773511, 81573214).

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  1. These authors contributed equally: Jing Dong, Li-Kun Hu

Authors and Affiliations

  1. Health Management Center, Xuanwu Hospital, Capital Medical University, Beijing, China

    Jing Dong & Xi Chu

  2. Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China

    Li-Kun Hu, Ya-Ke Lu, Yu-Hong Liu & Yu-Xiang Yan

  3. Municipal Key Laboratory of Clinical Epidemiology, Beijing, China

    Yu-Xiang Yan

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Contributions

Yu-Xiang Yan and Xi Chu conceived the topic and designed the research. Jing Dong, Li-Kun Hu, Ya-Ke Lu, and Yu-Hong Liu carried out the data cleaning and collation. Jing Dong and Li-Kun Hu undertook the data analysis and drafted the manuscript. Yu-Xiang Yan, Xi Chu, Ya-Ke Lu, and Yu-Hong Liu provided guidance and revised the manuscript. All authors read and approved the final manuscript.

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Correspondence to Xi Chu or Yu-Xiang Yan.

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Dong, J., Hu, LK., Lu, YK. et al. Association of serum uric acid with the risk of developing hypertension: A prospective cohort study with mediation analysis. Hypertens Res 46, 345–356 (2023). https://doi.org/10.1038/s41440-022-01081-1

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