Uric acid reduction rectifies prehypertension in obese adolescents.
Level 2 - randomized trial
Individual randomized, double-blind, placebo-controlled trial
PubMed 23006736 · doi:10.1161/HYPERTENSIONAHA.112.196980
What was done
In a randomized, double-blind, placebo-controlled clinical trial, obese adolescents aged 11 to 17 years with prehypertension were assigned to urate-lowering therapy—either the xanthine oxidase inhibitor allopurinol, the uricosuric probenecid—or placebo to evaluate if uric acid causatively mediates blood pressure elevation and impaired vascular compliance.
What was found
Subjects receiving urate-lowering therapy experienced a 10.2 mm Hg fall in clinic systolic blood pressure and a 9.0 mm Hg fall in diastolic blood pressure. In contrast, placebo patients experienced a rise of 1.7 mm Hg in systolic blood pressure and 1.6 mm Hg in diastolic blood pressure. Urate-lowering therapy also produced a significant reduction in systemic vascular resistance.
Why it matters
This indicates that uric acid is a causal driver of blood pressure elevation in early-stage prehypertension in youth, demonstrating that lowering urate can reverse blood pressure and vascular resistance elevations.
Limits
The abstract does not provide the sample size, treatment duration, drop-out rates, standard deviations, confidence intervals, or exact p-values. Outcomes are pooled for the two active drugs rather than reported separately, and findings in obese adolescents may not generalize to non-obese individuals or adults with long-standing hypertension.
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