Abstract 12539: Physical Activity, Uric Acid and Risk of Hypertension

Introduction: The association of uric acid with risk of hypertension is controversial and may be modulated by other risk factors. We did a prospective study to investigate whether uric acid was an independent predictor of risk of hypertension in the young and whether an unhealthy lifestyle could favour this association. Design and methods: The study was conducted in a cohort of 1060 young to middle age subjects screened for stage 1 hypertension and followed for a median of 11 years. In multivariable Cox analyses, data were adjusted for age, gender, body mass index (BMI), parental hypertension, 24-hour systolic and diastolic blood pressure, serum creatinine, lifestyle factors and metabolic data. Results: At baseline uric acid showed an independent positive association with male gender, BMI, creatinine and metabolic data and a negative association with age and smoking. The uric acid level was 5.03 mg/dL in the sedentary subjects (n=659) and 5.00 mg/dL in the active subjects (p=n.s.). At follow-up end, 677 subjects developed hypertension needing treatment. In the whole group, uric acid was an independent predictor of future hypertension (p=0.004). Participants with uric acid > 5.60 mg/dL (lower limit of the top tertile) had a 31% increase in risk compared to those of the bottom tertile. However, the risk of hypertension related to uric acid was increased only among the sedentary subjects (p=0.0017) with a hazard ratio of 1.43 (95%CI, 1.10-1.88) for the subjects of the top uric acid tertile compared to those of the bottom tertile. In contrast, among the active subjects no association was found between uric acid and risk of hypertension (p=0.56). The association between uric acid and future hypertension remained virtually unchanged when baseline serum glucose, cholesterol and triglycerides were included in the regression models. Conclusions: Uric acid is an independent predictor of hypertension in young to middle age subjects. However, regular physical activity prevents the development of hypertension related to hyperuricemia. These data suggest that exercise can counteract the pathophysiological mechanisms involved in the association between hyperuricemia and development of hypertension.