Association between hyperuricemia and incident heart failure among older adults

A propensity-matched study

O. James Ekundayo, Louis J. Dell'Italia, Paul W. Sanders, Donna Arnett, Inmaculada Aban, Thomas E. Love, Gerasimos Filippatos, Stefan D. Anker, Donald M. Lloyd-Jones, George Bakris, Marjan Mujib, Ali Ahmed

Research output: Contribution to journalArticle

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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 languageEnglish
Pages (from-to)279-287
Number of pages9
JournalInternational Journal of Cardiology
Volume142
Issue number3
DOIs
Publication statusPublished - Jul 23 2010

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Hyperuricemia
Heart Failure
Confidence Intervals
Uric Acid
Independent Living
Sodium Chloride Symporter Inhibitors
Propensity Score
Xanthine Oxidase
Hyperinsulinism
Serum

Keywords

  • Incident heart failure
  • Kidney function
  • Propensity score
  • Uric acid

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Ekundayo, O. J., Dell'Italia, L. J., Sanders, P. W., Arnett, D., Aban, I., Love, T. E., ... Ahmed, A. (2010). Association between hyperuricemia and incident heart failure among older adults: A propensity-matched study. International Journal of Cardiology, 142(3), 279-287. https://doi.org/10.1016/j.ijcard.2009.01.010

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 journalArticle

Ekundayo, OJ, Dell'Italia, LJ, Sanders, PW, Arnett, D, Aban, I, Love, TE, Filippatos, G, Anker, SD, Lloyd-Jones, DM, Bakris, G, Mujib, M & Ahmed, A 2010, 'Association between hyperuricemia and incident heart failure among older adults: A propensity-matched study', International Journal of Cardiology, vol. 142, no. 3, pp. 279-287. https://doi.org/10.1016/j.ijcard.2009.01.010
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. / Association between hyperuricemia and incident heart failure among older adults : A propensity-matched study. In: International Journal of Cardiology. 2010 ; Vol. 142, No. 3. pp. 279-287.
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AU - Filippatos, Gerasimos

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