Hyperuricemia and Its Correlation with Target Organ Damage and Electrocardiographic Changes in Newly Diagnosed Adult Nigerian Hypertensive Patients
Clinical Medicine Research
Volume 7, Issue 1, January 2018, Pages: 1-7
Received: Mar. 10, 2017;
Accepted: Apr. 10, 2017;
Published: Jan. 26, 2018
Views 2215 Downloads 109
Abidemi Jude Fasae, Department of Internal Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria
Olusegun Adesola Busari, Department of Internal Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria
Rotimi Oluyombo, Department of Internal Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria
Musa Yusuf, Department of Internal Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria
Oladipo George Opadijo, Department of Internal Medicine, Ladoke Akintola University Teaching Hospital, Ogbomoso, Nigeria
Ayodele Babatunde Omotoso, Department of Internal Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
The objective of the study was to determine the prevalence of Hyperuricemia and evaluate its correlation with target organ damage and electrocardiographic changes in newly diagnosed adult Nigerian hypertensive patients. It was a cross sectional study done at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. 150 untreated newly diagnosed hypertensive patients 18 years and above and 115 age and sex-matched normotensive individuals were recruited into the study. Data obtained was analyzed using Epi-Info version 6.04 and Statistical Package for Social Sciences (SPSS) version 14 computer software packages. The prevalence of Hyperuricemia was 36.7% and 17.4% in hypertensive patients and normotensive controls respectively. Mean serum UA in hypertensive patients and normotensive controls was 0.4±0.1mmol/l and 0.3±0.1mmol/l respectively (p<0.0001). There was an association between Hyperuricemia and left ventricular hypertrophy (x2=23.97, p<0.0001). The study showed that Hyperuricemia is prevalent in adult Nigerians with newly diagnosed hypertension. Hyperuricemia was associated with left ventricular hypertrophy which is common target organ damage and confers an increased risk of cardiovascular events in systemic hypertension.
Abidemi Jude Fasae,
Olusegun Adesola Busari,
Oladipo George Opadijo,
Ayodele Babatunde Omotoso,
Hyperuricemia and Its Correlation with Target Organ Damage and Electrocardiographic Changes in Newly Diagnosed Adult Nigerian Hypertensive Patients, Clinical Medicine Research.
Vol. 7, No. 1,
2018, pp. 1-7.
Kearney PM, Whelton M, Reynolds K, Whelton PK, He J. Worldwide prevalence of hypertension: A systematic review. J Hypertens 2004; 22(1):11–9.
Kearney PM, Whelton M, Reynolds K, Munter P, Whelton PK, He J. Global burden of hypertension: Analysis of worldwide data. Lancet 2005; 365 (9455):217–23.
Rotimi CN. Hypertension in Blacks. Am J Hypertens 1997; 10: 804-12.
Isezuo SA. Systemic hypertension in Blacks. An overview of current concepts of pathogenesis and management. Nig Postg Med Journal. 2003; 10(3):144-153.
Phyllis A. Initial management of hypertension. N Eng J Med. 2003; 348: 610-617.
Epidemiology of Cardiovascular Disease in the 21st Century: Updated Numbers and Updated Facts. Journal of Cardiovascular Disease. 2013; 1(1): 2326-3121.
Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380(9859):2224-60.
Santulli G. Coronary heart disease risk factors and mortality. JAMA. 2012; 307(11): 1137-1138.
Akinkugbe OO. The epidemiology of hypertension in Africa. In: Akinkugbe, ed. Cardiovascular diseases in Africa. Ciba-Geigy. 1976; 91-10.
Adedoyin RA, Mbada CE, Balogun MO, Martins T, Adebayo RA, Akintomide A, et al. Prevalence and pattern of hypertension in a semiurban community in Nigeria. Eur J Cardiovasc Prev Rehabil. 2008; 15(6):683-7.
Ofuya Z. The incidence of hypertension among a select population of adults in the Niger Delta region of Nigeria. Southeast Asian J Trop Med Public Health 2007; 38 (5): 947-9.
Akinkungbe OO, Oladipo B. Current epidemiology of hypertension in Nigeria. Archives of Ibadan Medicine 2001; 1(1): 4-8.
Oladapo OO, Salako L, Sodiq O, Shoyinka K, Adedapo K, Falase AO. A prevalence of cardiometabolic risk factors among a rural Yoruba south-western Nigerian population: a population-based survey. Cardiovasc J Afr. 2010; 21(1):26-31.
Kannel WB. Blood pressure as a cardiovascular risk factor. JAMA1996; 275:157-160.
Levi D, Larson MG, Vassan RS, Kannel WB. The progression from hypertension to congestive heart failure. JAMA. 1996; 275: 1557-15562.
Falase AO, Ayeni O, Sekoni GA, Odia OJ. Heart failure in Nigerian hypertensives. Afri J Med Sci. 1983; 12:7-15.
Wilson PW. Established risk factors and coronary artery disease: The Framingham study. Am J Hypertens 1994; 7: 7S.
Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. American Heart Association Statistics C and Stroke Statistics S. Heart disease and stroke statistics--2013 update: A report from the American Heart Association. Circulation 2013; 12 7(1):e6-e245.
The Hypertension Detection and Follow-up program Cooperative group: Findings for stepped care and referred care participants in the HDFP, stratified by risk factors. Prev Med. 1985; 14: 312-335.
Heyden S, Bohrani NO, Tyroler HA. The relationship of weight changes in blood pressure, serum uric acid, cholesterol and glucose in the treatment of hypertension. J Chro Dis. 1985; 38: 281-288.
Obeka N C. Serum uric acid and lipid profile in hypertensive adult Nigerians. Dissertation for the West African College of Physicians. April 2004.
Adedeji OO, Onitiri AC. Plasma lipids and Nigerian hypertensives. Afri J med Sci. 1990; 19: 281-284.
Abengowe, CU. Serum uric acid values, hypertension and alcohol consumption in Nigerian men. Trop Card 1987; 13(51): 100-112.
WHO Working group. Use and interpretation of anthropometric indications of nutritional status. Bulletin of the World health Organization.1986; 64: 929-941.
Ukoh VA, OforofuoI AO. A comparative study of body mass index and waist-hip ratio in relation to serum lipids amongst hypertensive and normotensive Nigerians. Trop Card. 1999; 25 (97):7-10.
The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Arch Int Med. 1997; 157: 2413-4.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure: JNC 7 Report. JAMA 2003; 289: 2560-72.
World Health Organization (WHO)/ International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens 2003; 32: 1983-92.
Friedewald WT, Levy RL, Fredrickson DS. Estimation of the concentration of low density lipoprotein cholesterol in plasma without use of the preparative ultracentrifuge. Clin Chem. 1972; 18: 499–502.
Araoye MA, Olowoyeye O, The clinical spectrum of Hypertensive Heart Failure: A Point Score System for solving an old problem. E Afri Med J 1984; 61 (4): 306-315.
Keith NM, Wagener HP, Barker NW. Some different types of essential hypertension: their course and prognosis. Am J Med Sci 1939; 197: 332-343.
Araoye M. A. Left Ventricular Hypertrophy by Electrocardiogram. A code system applicable to Negroes. Nig Postgrad Med J.1996; 3:92-97.
Araoye M. A. Left Ventricular Hypertrophy by Electrocardiogram. Letter to the Editor, Nig Postgrad Med J. 1999; 6: 189.
Macruz R, Perloff JK, Case RB. A method for the electrocardiographic recognition of atrial enlargement. Circulation 1958; 17:882-889.
Murugan PR, Padmacathi T. A study of prevalence of Hyperuricemia in hypertension. International Journal Of Recent Scientific Research 2015; 6(7): 5257-59.
Puig J. G., Torres R, Ruilope L. M AT1 blockers and uric acid metabolism: are there relevant differences? Hypertens 2002; 20(S5); 529-32.
Francesca S. Stefano P. Giovanni T et al. Serum uric acid and related factors in 500 hospitalized subjects. Metal 1996; 45 (12): 1557-1561.
Johnson RJ, Kang DH, Feig D, Kivlighn S, Kanellis J, Watanabe S, et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension 2003; 41(6):1183–1190.
Mene P, Punzo G. Uric acid: bystander or culprit in hypertension and progressive renal disease? Journal of Hypertension 2008; 26(11):2085–2092.
Khosla UM, Zharikov S, Finch JL, Nakagawa T, Roncal C, Mu W, et al. Hyperuricemia induces endothelial dysfunction. Kidney International 2005; 67(5):1739–1742.
Farquharson CA, Butler R, Hill A, Belch JJ, Struthers AD. Allopurinol improves endothelial dysfunction in chronic heart failure. Circulation 2002; 106(2):221–226.
Doehner W, Schoene N, Rauchhaus M, Leyva-Leon F, Pavitt DV, Reaveley DA, et al. Effects of xanthine oxidase inhibition with allopurinol on endothelial function and peripheral blood flow in hyperuricemic patients with chronic heart failure: results from 2 placebo-controlled studies. Circulation 2002; 105 (22): 2619–2624.
Mazzali M, Kanellis J, Han L, Feng L, Xia YY, Chen Q, et al. Hyperuricemia induces a primary renal arteriolopathy in rats by a blood pressure-independent mechanism. American Journal of Physiology 2002; 282(6 51-6): F991–F997.
Rao GN, Corson MA, Berk BC. Uric acid stimulates vascular smooth muscle cell proliferation by increasing platelet-derived growth factor A-chain expression. J Biol Chem. 1991; 266(13):8604–8608.
Perlstein TS, Gumieniak O, Hopkins PN, Murphey LJ, Brown NJ, Williams GH, et al. Uric acid and the state of the intrarenal renin-angiotensin system in humans. Kidney International 2004; 66(4): 1465–1470.
Toma I, Kan J, Meer E, Pet-Peterdi J. Uric acid triggers renin release via a macula densa-dependent pathway. Presented at: American Society of Nephrology Annual Meeting; San Francisco, CA. 2007. F-P0240.
Ruilope L. M., Garcia – Puig J. Hyperuricemia and renal function. Curr Hypertens Rep. 2001; 197-202.
Viazzi F, Parodi D, Leoncini G et al. Serum uric acid and target organ damage in primary hypertension. Hypertension 2005; 45: 991-6.
Lorenz CH, Walker ES, Morgan VL et al. Normal human right and left ventricular mass, systolic function and gender differences by cine magnetic resonance imaging. J Cardiovasc Magn Reson. 1999; 1(1):7– 21.
Sandstede J, Lipke C, Beer M et al. Age and gender specific differences in left and right ventricular cardiac function and mass determined by cine magnetic resonance imaging. European Radiology 2000; 10 (3):438 – 42.
Giuseppe M, Giovanni C. The metabolic syndrome and its relationship to hypertensive target organ damage. Clin Hypertens 2006; 8:195-201.
Mule G, Nardi E, Cottone S et al. Influence of metabolic syndrome on hypertension – related target organ damage. J. Intern. Med. 2005; 257: 503-13.
Raeven GM. Banting lecture 1988. Role of insulin resistance in human diseases. Diabetes 1988; 37:1595-1607.
Kaplan NM. The deadly quartet: Upper body adiposity, glucose intolerance, hypertriglyceridemia and hypertension. Arch Intern Med. 1989; 149:1514–20.
Straus DS. Growth –stimulatory actions of insulin in vitro and in vivo. Endocr Rev. 1984; 5: 356-69.
Andronico G, Wangano MT, Mule G. et al. Insulin-like growth factor 1 and sodium-lithium counter transport in essential hypertension and in hypertensive left ventricular hypertrophy. Hypertens 1993; 11: 1097-101.
Schlaich MP, Kaye DM, Lambert E et al. Relation between cardiac sympathetic activity and hypertensive left ventricular hypertrophy. Circulation 2003; 108: 560-65.