Dose-response association between serum uric acid levels and incident hypertension: a systematic review and meta-analysis of 17 prospective cohort studies of 32 thousand participants.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of prospective cohort studies
PubMed 32539677 · doi:10.1080/00015385.2020.1779476
What was done
Authors searched PubMed and Embase through October 21, 2019, to evaluate the association and dose-response relationship between serum uric acid (SUA) levels and incident hypertension (IHTN). Random-effects models were used to calculate pooled relative risks (RRs) and 95% confidence intervals (CIs). Restricted cubic splines were applied to model the dose-response relationship.
What was found
The meta-analysis included 17 prospective cohort studies encompassing 321,716 adults and 65,890 incident hypertension cases. Each 1 mg/dL increase in SUA level was associated with a pooled RR for incident hypertension of 1.10 (95% CI: 1.07–1.13; n = 17) with high between-study heterogeneity (I² = 90.7%). The dose-response association appeared linear (P for non-linearity = 0.069).
Why it matters
The findings quantify a consistent, linear risk increase for developing hypertension with higher baseline serum uric acid concentrations across prospective human cohorts.
Limits
All included evidence was observational (prospective cohort studies), preventing determination of causality. Statistical heterogeneity across studies was extremely high (I² = 90.7%). Specific confounding variables, underlying baseline population characteristics, and study-level definitions of hypertension were not detailed in the abstract.
Cited by
- supports Elevated serum uric acid independently predicts the future development of hypertension, obesity, and diabetes.
- supports The relationship between serum uric acid levels and blood pressure is linear across a wide range.