Prevalence of Hyperuricemia (HU) in Arterial Hypertension
Bâ Hamidou Oumar1, Menta Ichaka1, Maiga Asmaou Kéita2, Daou Adama3, Diall Ilo Bella4, Coulibaly Souleymane4, Doumbia Coumba Thiam3, Daffé Sanoussi3, Sidibé Noumou1, Sangaré Ibrahima1, Millogo Georges Rosario Christian5, Touré Mamadou1, Sidibé Salimata4, Diarra Mamadou Bocary3
1University Hospital «Gabriel Touré», Cardiology, Bamako, Mali
2University Hospital «Le Luxembourg », Cardiology, Bamako, Mali
3National support center for the fight against the disease, Bamako, Mali
4University Hospital «Point G», Cardiology, Bamako, Mali
5University Hospital «Yalgado Ouedraogo», Cardiology, Ouagadougou, Burkina, Faso
To cite this article:
Bâ Hamidou Oumar, Menta Ichaka, Maiga Asmaou Kéita, Daou Adama, Diall Ilo Bella, Coulibaly Souleymane, Doumbia Coumba Thiam, Daffé Sanoussi, Sidibé Noumou, Sangaré Ibrahima, Millogo Georges Rosario Christian, Touré Mamadou, Sidibé Salimata, Diarra Mamadou Bocary. Prevalence of Hyperuricemia (HU) in Arterial Hypertension. Science Journal of Clinical Medicine. Vol. 4, No. 4, 2015, pp. 76-79. doi: 10.11648/j.sjcm.20150404.12
Abstract: Introduction: Hyperuricemia constitutes a risk for many organs and its prevalence is high ranging from 15-20% up to 35% in developing countries. HU relation to arterial hypertension was pointed out in the end of the XIX century and is recognized as independent cardiovascular risk factor. Thus HU is less studied in our environment which justifies our work to determine prevalence and with HU associated factors among hypertensive patients followed in the Cardiology department in the Mother Child Hospital "Le Luxembourg". Methodology: It’s was a cross-sectional study in the Mother-Child Hospital "Le Luxembourg" in Bamako. All patients with complete labor tests were included making a sample of 51 hypertensive outpatients seen from July 2010 to January 2011. For any included patient, socio-demographic and biological variables were collected. In the same way a chest radiography, an ECG and an echocardiography were realized. Patients were asked about their knowledge about HU Hyperuricemia was defined as an uricemia > 420 μmol/l for men and 360 μmol/l for women. Microsoft Excel 2007 was used to gather data and SPSS version 12 to perform analyzes. Results: Mean age of the sample was 56,35 years, the sex-ratio Male: Female 0,76. Hyperuricemia, hypercreatininemia and hyperglycemia were found respectively in 66,7,33,3% and 23,5% of the cases. 78,4% of the patients had stated to have heard about hyperuricemia, 27,5% knew their hyperuricemia. The socio-demographic characteristics did not present a statistically significant difference. Conclusion: Hyperuricemia as a cardiovascular risk factor, had to be researched and managed more agressively. The very high proportion of patients with a hyperuricemia requires to detect it among hypertensive patients, to carry out an early treatment and thus to reduce the cardiovascular risk of the patient.
Keywords: Hypertension, Hyperuricemia, Cardiology, Bamako
Hyperuricemia is a frequent biochemical anomaly, resulting from an excessive production of urate and/or a decreased renal excretion of uric acid. The risk of development of a gout is increased for concentrations higher than 600 μmol/l [1,2].
The relative risk to develop an HT increases with the uricemia, HT incidence increases approximately 7% for each increase of 14 mg/l (83 µmol/l) of uricemia (ARIC study), for each increase of 60 µmol/l of uricemia, the relative cardiovascular risk was 1,09 in man and 1,26 in woman (study NHANES). In the same way an association between serum uric acid and cardiovascular events in hypertensive women was supported, and a reduction of serum uric acid may be due by specific medicament .
Little is known about HU in our working environment so that this condition need to be explored and motivated this work that tries to determine the prevalence and with HU associated factors among hypertensive patients followed in the service with Cardiology with the Hospital Mother Child "Luxembourg", is the reason for this work.
The cross-sectional study was performed in the Mother-Child Hospital "Le Luxembourg" from July 2010 to January 2011
All hypertensive outpatients seen in the Mother-Child Hospital and with full clinical and labor tests data were included.
HT patients with incomplete labor tests were not included.
For any included patient, socio-demographic, cardiovascular risk factors, clinical data and biological variables were collected.
Body mass index (BMI) was calculating using weight in Kg and height in m as weight/height2. Overweight, Obese and underweight were defined as BMI resp. ≥ 25 Kg/m2, ≥ 30 Kg/m2 and < 18,5.
In the same way data on chest radiography, electrocardiogram (ECG) and an echocardiography were realized.
HU was defined as a serum uric acid level > 420 μmol/l for men and 360 μmol/l for women.
A qualitative appreciation (normal or anormal) was used for uric acid, glycemy, serum creatinine as well for radiographic, electrocardiographic and echocardiographic data. study.
Further patients were asked about their knowledge about HU using 5 questions:
• Have you heard about hyperuricemia
• Do you have an hypericemia?
• If yes how long ?
• Do you take medication against hyperuricemia ?
• If yes which medications?
Microsoft Excel 2007 was used to gather data and SPSS version 12 to perform analyzes.
Analyzes were performed in 2 stages : a first descriptive part and a second analytic part.
Significantly were tests for a p-value of less than 0,05
Patients had to freely choose to be included or not without any consequence about their further management.
3.1. Descriptive Study
The sample size was 51 hypertensive patients, with an mean age of 56,35 years and an mean duration of HT of 10,73 months. The others characteristics of the sample are shown in Table 1.
Patients aged from 46 - 60 and those over 60 years represented the majority with respectively 39,2%,37,3% and the sex ratio Male: Female was 0,76 (Table 2).
47,1% had HT diagnosed for less than 6 months, Diabetes and Gout were found in respectively 15,7% and 5,9%. Cardiac disease was found in 3,9% of all cases and obese patients made 41,2% of the sample (Table 3).
HU, high serum creatinine and hyperglycemia were found respectively in 66,7,33,3% and 23,5% of all cases, while 27,5% had a cardiomegaly on chest radiography and 92,2% a pathological echocardiography (Table 4).
78,4% of the patients had stated to have heard about HU, 27,5% knew their hyperuricemic condition.
|Systolic pressure (mmHg)||100,00||163,14||240,00||29,97|
|Diastolic pressure (mmHg)||70,00||98,02||169,00||14,74|
*: body mass index; ** Heart Rate
|Age group (years )||< 30||2||2,0|
|Out of Bamako||10||19,6|
|HT duration ( months)||< 6||24||47,1|
*Gastro-duodenal ulcer, Asthma bronchiale, functional Colopathy
* Cardio-thoracic index **Left ventricular hypertrophy
3.2. Analytical Study
The socio-demographic variables did not present a statistically significant difference. HU seemed more prevalent among female sex, in the age group >= 61 years and among Housewives with respectively 75,9% (p=0,11), 68,4% (p=0,87) and 71,4% (p=0,98).
HU was found in 83,3% among obese patients (p=0,64), 64,1% of the sedentaries (p=0,48) and 83,3% of the diabetes patients (p=0,25).
71,4% of the patients having a cardiac enlargement and 54,5% with a left ventricular hypertrophy had an HU (p=0,39 respectively 0,11) (Table 5).
We did not find in the sample patients presenting an anomaly of LDL-Cholesterol or triglycerides.
|Age (years)||< 30||0,0||100,0||0,87|
* Body mass index, ** Electrocardiogram
Our study was realized on a sample of adults patients with a mean age of 56,35 years.
HU prevalence was 66,7% (75,9% in female sex and 35,3% in male sex) which is consistent with literature data ranging from 25 to 75% [10,15] and the HU is considered as cardiovascular risk factor [9-11,13,14], requiring a more aggressive management of patients having an HU.
The mean uricemia was 440,067 (413,01 in female and 475,73 in male).
We did not find a statistically significant difference in age groups, sex and profession.
If HU was frequent in our sample (4) only 27,5% of the patients were informed about this anomaly even if 78,4% of the patients stated to have heard about HU. This fact underlines the ignorance of the cardiovascular risk factors and thus the difficulty related to their management and thus requires broader information of the patients on these factors.
In addition the high percentage of patients with an HU implies to seek it among HT patients and to avoid the potentiation of the cardiovascular risk factors.
The high proportion of HT patients with HU pointed out the need for large sample studies to better characterize HU.
Hyperuricemia as a cardiovascular risk factor had to be researched and managed more agressively. The very high proportion of patients with a HU requires to detect it among hypertensive patients, to carry out an early treatment and thus to reduce the cardiovascular risk of the patient.