Serum uric acid and risk of prehypertension: a dose-response meta-analysis of 17 observational studies of approximately 79 thousand participants.
Level 2 - randomized trial
Systematic review and meta-analysis of observational studies
PubMed 33683186 · doi:10.1080/00015385.2021.1878422
What was done
A systematic review and dose-response meta-analysis of observational studies was performed by searching PubMed, Embase, and Web of Science up to December 3, 2019. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random-effects models. Linear or non-linear dose-response relationships were evaluated using restricted cubic splines. The analysis included 17 observational studies with 79,358 participants and 34,591 cases of prehypertension.
What was found
Compared with the lowest serum uric acid (SUA) levels, the highest SUA levels were associated with a 46% increased risk of prehypertension (RR 1.46, 95% CI 1.28-1.66). Each 1 mg/dL increment in SUA was associated with a 12% increase in prehypertension risk (RR 1.12, 95% CI 1.08-1.17). Spline analysis demonstrated a linear association (P non-linearity = .368).
Why it matters
This meta-analysis demonstrates a clear linear dose-response association between higher serum uric acid concentrations and increased prehypertension risk across pooled populations. It highlights uric acid as an observational risk marker, though intervention trials are needed to determine if lowering uric acid prevents prehypertension.
Limits
All included data derive from observational studies, which cannot establish causality and remain vulnerable to residual confounding. The abstract does not detail the proportion of prospective versus cross-sectional designs, patient demographics, or the degree of covariate adjustment in the primary studies.
Cited by
- supports The relationship between serum uric acid levels and blood pressure is linear across a wide range.