Abstract
Background: The association between hyperuricemia and incident heart failure (HF) is relatively unknown. Methods: Of the 5461 community-dwelling older adults, ≥ 65 years, in the Cardiovascular Health Study without HF at baseline, 1505 had hyperuricemia (baseline serum uric acid ≥ 6 mg/dL for women and ≥ 7 mg/dL for men). Using propensity scores for hyperuricemia, estimated for each participant using 64 baseline covariates, we were able to match 1181 pairs of participants with and without hyperuricemia. Results: Incident HF occurred in 21% and 18% of participants respectively with and without hyperuricemia during 8.1 years of mean follow-up (hazard ratio {HR} for hyperuricemia versus no hyperuricemia, 1.30; 95% confidence interval {CI}, 1.05-1.60; P = 0.015). The association between hyperuricemia and incident HF was significant only in subgroups with normal kidney function (HR, 1.23; 95% CI, 1.02-1.49; P = 0.031), without hypertension (HR, 1.31; 95% CI, 1.03-1.66; P = 0.030), not receiving thiazide diuretics (HR, 1.20; 95% CI, 1.01-1.42; P = 0.044), and without hyperinsulinemia (HR, 1.35; 95% CI, 1.06-1.72; P = 0.013). Used as a continuous variable, each 1 mg/dL increase in serum uric acid was associated with a 12% increase in incident HF (HR, 1.12; 95% CI, 1.03-1.22; P = 0.006). Hyperuricemia had no association with acute myocardial infarction or all-cause mortality. Conclusions: Hyperuricemia is associated with incident HF in community-dwelling older adults. Cumulative data from our subgroup analyses suggest that this association is only significant when hyperuricemia is a marker of increased xanthine oxidase activity but not when hyperuricemia is caused by impaired renal elimination of uric acid.
| Original language | English |
|---|---|
| Pages (from-to) | 279-287 |
| Number of pages | 9 |
| Journal | International Journal of Cardiology |
| Volume | 142 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Jul 23 2010 |
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Keywords
- Incident heart failure
- Kidney function
- Propensity score
- Uric acid
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Medicine(all)
Cite this
Association between hyperuricemia and incident heart failure among older adults : A propensity-matched study. / Ekundayo, O. James; Dell'Italia, Louis J.; Sanders, Paul W.; Arnett, Donna; Aban, Inmaculada; Love, Thomas E.; Filippatos, Gerasimos; Anker, Stefan D.; Lloyd-Jones, Donald M.; Bakris, George; Mujib, Marjan; Ahmed, Ali.
In: International Journal of Cardiology, Vol. 142, No. 3, 23.07.2010, p. 279-287.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Association between hyperuricemia and incident heart failure among older adults
T2 - A propensity-matched study
AU - Ekundayo, O. James
AU - Dell'Italia, Louis J.
AU - Sanders, Paul W.
AU - Arnett, Donna
AU - Aban, Inmaculada
AU - Love, Thomas E.
AU - Filippatos, Gerasimos
AU - Anker, Stefan D.
AU - Lloyd-Jones, Donald M.
AU - Bakris, George
AU - Mujib, Marjan
AU - Ahmed, Ali
PY - 2010/7/23
Y1 - 2010/7/23
N2 - Background: The association between hyperuricemia and incident heart failure (HF) is relatively unknown. Methods: Of the 5461 community-dwelling older adults, ≥ 65 years, in the Cardiovascular Health Study without HF at baseline, 1505 had hyperuricemia (baseline serum uric acid ≥ 6 mg/dL for women and ≥ 7 mg/dL for men). Using propensity scores for hyperuricemia, estimated for each participant using 64 baseline covariates, we were able to match 1181 pairs of participants with and without hyperuricemia. Results: Incident HF occurred in 21% and 18% of participants respectively with and without hyperuricemia during 8.1 years of mean follow-up (hazard ratio {HR} for hyperuricemia versus no hyperuricemia, 1.30; 95% confidence interval {CI}, 1.05-1.60; P = 0.015). The association between hyperuricemia and incident HF was significant only in subgroups with normal kidney function (HR, 1.23; 95% CI, 1.02-1.49; P = 0.031), without hypertension (HR, 1.31; 95% CI, 1.03-1.66; P = 0.030), not receiving thiazide diuretics (HR, 1.20; 95% CI, 1.01-1.42; P = 0.044), and without hyperinsulinemia (HR, 1.35; 95% CI, 1.06-1.72; P = 0.013). Used as a continuous variable, each 1 mg/dL increase in serum uric acid was associated with a 12% increase in incident HF (HR, 1.12; 95% CI, 1.03-1.22; P = 0.006). Hyperuricemia had no association with acute myocardial infarction or all-cause mortality. Conclusions: Hyperuricemia is associated with incident HF in community-dwelling older adults. Cumulative data from our subgroup analyses suggest that this association is only significant when hyperuricemia is a marker of increased xanthine oxidase activity but not when hyperuricemia is caused by impaired renal elimination of uric acid.
AB - Background: The association between hyperuricemia and incident heart failure (HF) is relatively unknown. Methods: Of the 5461 community-dwelling older adults, ≥ 65 years, in the Cardiovascular Health Study without HF at baseline, 1505 had hyperuricemia (baseline serum uric acid ≥ 6 mg/dL for women and ≥ 7 mg/dL for men). Using propensity scores for hyperuricemia, estimated for each participant using 64 baseline covariates, we were able to match 1181 pairs of participants with and without hyperuricemia. Results: Incident HF occurred in 21% and 18% of participants respectively with and without hyperuricemia during 8.1 years of mean follow-up (hazard ratio {HR} for hyperuricemia versus no hyperuricemia, 1.30; 95% confidence interval {CI}, 1.05-1.60; P = 0.015). The association between hyperuricemia and incident HF was significant only in subgroups with normal kidney function (HR, 1.23; 95% CI, 1.02-1.49; P = 0.031), without hypertension (HR, 1.31; 95% CI, 1.03-1.66; P = 0.030), not receiving thiazide diuretics (HR, 1.20; 95% CI, 1.01-1.42; P = 0.044), and without hyperinsulinemia (HR, 1.35; 95% CI, 1.06-1.72; P = 0.013). Used as a continuous variable, each 1 mg/dL increase in serum uric acid was associated with a 12% increase in incident HF (HR, 1.12; 95% CI, 1.03-1.22; P = 0.006). Hyperuricemia had no association with acute myocardial infarction or all-cause mortality. Conclusions: Hyperuricemia is associated with incident HF in community-dwelling older adults. Cumulative data from our subgroup analyses suggest that this association is only significant when hyperuricemia is a marker of increased xanthine oxidase activity but not when hyperuricemia is caused by impaired renal elimination of uric acid.
KW - Incident heart failure
KW - Kidney function
KW - Propensity score
KW - Uric acid
UR - http://www.scopus.com/inward/record.url?scp=77956875084&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77956875084&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2009.01.010
DO - 10.1016/j.ijcard.2009.01.010
M3 - Article
VL - 142
SP - 279
EP - 287
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 3
ER -