Prevalence and factors associated with hyperuricaemia in newly diagnosed and untreated hypertensives in a sub-Saharan African setting

Hyperuricemia and associated factors among hypertensive patients attending an academic hospital of Ethiopia: A cross-sectional study

Background

Hypertension is a major public health problem in developing countries. Globally, nearly 1.13 billion adults had hypertension in 2015 and this is estimated to increase to 1.56 billion by 2025. Hyperuricemia is an important predictor of the progression of hypertension and is common in hypertensive patients. Hypertensive patients with hyperuricemia are at higher risk of cardiovascular disease.

Objective

To assess the prevalence of hyperuricemia and its associated factors among hypertensive patients attending the University of Gondar Comprehensive Specialized Hospital (UGCSH).

Method

An institutional-based cross-sectional study was conducted on 248 hypertensive patients attending the University of Gondar Comprehensive Specialized Hospital from January 2020 to February 2021. A convenient sampling technique was employed to select study participants. Socio-demographic and clinical characteristics were collected using a structured questionnaire via face-to-face interviews and reviewing medical records respectively. The biochemical parameters were measured by using a Mindray BS-200E chemistry analyzer. Data was entered using EpiData version 4.6.0.0 and analyzed using STATA vs. 14.0. Bivariable and multivariable binary logistic regression were fitted to identify factors associated with hyperuricemia. The odds ratio and 95 % CI were calculated to assess the strength of the association and a P-value <0.05 in the multivariable was considered statistically significant.

Results

A total of 248 patients were enrolled; 140 (56.5 %) were female. The mean age of patients was 57.9 ± 10.5 years. The overall prevalence of hyperuricemia was 42.3 %; males had a prevalence of 36.1 % and females of 47.1 %. High waist circumference, high body mass index, dyslipidemia, low estimated Glomerular Filtration Rate, elevated fasting blood glucose, elevated total cholesterol, elevated triglycerides, elevated Low-Density Lipoprotein cholesterol, and Low High-Density Lipoprotein cholesterol were found to be significantly associated with hyperuricemia.

Conclusion

This study demonstrated the predominant existence of hyperuricemia in hypertensive patients. Therefore, early diagnosis and monitoring of hyperuricemia are required before further complications occur.

Hyperuricemia and its related diseases: mechanisms and advances in therapy

Hyperuricemia, characterized by elevated levels of serum uric acid (SUA), is linked to a spectrum of commodities such as gout, cardiovascular diseases, renal disorders, metabolic syndrome, and diabetes, etc. Significantly impairing the quality of life for those affected, the prevalence of hyperuricemia is an upward trend globally, especially in most developed countries. UA possesses a multifaceted role, such as antioxidant, pro-oxidative, pro-inflammatory, nitric oxide modulating, anti-aging, and immune effects, which are significant in both physiological and pathological contexts. The equilibrium of circulating urate levels hinges on the interplay between production and excretion, a delicate balance orchestrated by urate transporter functions across various epithelial tissues and cell types. While existing research has identified hyperuricemia involvement in numerous biological processes and signaling pathways, the precise mechanisms connecting elevated UA levels to disease etiology remain to be fully elucidated. In addition, the influence of genetic susceptibilities and environmental determinants on hyperuricemia calls for a detailed and nuanced examination. This review compiles data from global epidemiological studies and clinical practices, exploring the physiological processes and the genetic foundations of urate transporters in depth. Furthermore, we uncover the complex mechanisms by which the UA induced inflammation influences metabolic processes in individuals with hyperuricemia and the association with its relative disease, offering a foundation for innovative therapeutic approaches and advanced pharmacological strategies.

Hyperuricemia and associated factors: The case of outpatients at the Bafoussam Regional Hospital- Cameroon, an analytical cross-sectional study

BACKGROUND AND AIMS

Hyperuricemia constitutes a major public health issue due to its implication in many chronic diseases and metabolic syndromes. We propose to study the prevalence and associated factors of hyperuricemia to diagnose asymptomatic patients and make prognoses on the state of health of the patients.

METHODS

An analytic cross-sectional study has been carried out at the Bafoussam Regional Hospital and the Biochemistry laboratory of the Université des Montagnes over 2 months. Sociodemographic and anthropometric characteristic was obtained; a blood sample was collected from the chosen patients and a biochemical test (uric acid, creatinine, urea, total cholesterol, high density lipoproteins cholesterol, triglyceride) was analyzed by spectrophotometric method. Statistical tests were carried out using SPSS statistical software. Logistic regression analyses identified factors associated with variables of interest. The significance was measured by a p < 0.05 with a confidential level of 95%.

RESULTS

The patient population was made up of 100 patients. The sex ratio was 1.22 in favor of men. The prevalence of hyperuricemia in our study was 28.0% with 31.1% in women and 27.3% in men. The mean average of uric acid in the hyperuricemia population was 7.50 ± 1.24 mg/L and the normal uricemia population was 4.69 ± 1.49 mg/L (p < 0.0001). The mean average triglyceride in the hyperuricemia population was 143 ± 14 and 117.55 ± 55.52 mg/dL in normal uricemia with p = 0.046. Age range [35-45] and hypertriglyceridemia have been associated with hyperuricemia with respectively (odds ratio [OR] = 4.07, p < 0.015) confidence interval, CI: [0.89: 97.0]) and ([OR = 2.50, p < 0.046] CI: [1.01: 6.09]).

CONCLUSION

The prevalence of hyperuricemia was relatively high and has been associated with metabolic disorders in the population. It is necessary to focus on early diagnoses, treatment, and early intervention in view to prevent chronic diseases associated with hyperuricemia.

Prevalence and Predictors of Renal Disease in a National Representative Sample of the Romanian Adult Population: Data from the SEPHAR IV Survey

Background: The prevalence of chronic kidney disease (CKD) correlates with the prevalence of hypertension (HT). We studied the prevalence and predictors of CKD in a representative sample of the Romanian adult population. Methods: A sample of 1470 subjects were enrolled in the SEPHAR IV (Study for the Evaluation of Prevalence of Hypertension and Cardiovascular Risk) survey. All subjects were evaluated for blood pressure (BP) and extensive evaluations of target organ damage, blood, and urine samples were undertaken. Results: A total of 883 subjects were included in the statistical analysis. Those experiencing CKD with an eGFR < 60 mL/min/1.73 m2 were older at 71.94 ± 7.4 years (n = 19, 2.15%) compared with those without renal impairment at 50.3 ± 16.21 years (n = 864, 97.85%), p < 0.0001. The prevalence of CKD among hypertensives (379 from 883) was 4.49% (17/379), while 17 out of 19 subjects with CKD had HT (89.47%). After adjusting for age, sex, and diabetic status, only serum uric acid (SUR) > 6.9 mg/dL (OR: 6.61; 95% CI: 2.063, 10.83; p = 0.004) was an independent risk factor and a predictor of CKD. Conclusions: The prevalence of CKD in hypertensive Romanian adults was more than ten times higher than in the normotensive population. Levels of SUR > 6.9 mg/dL were predictors of CKD.

Markers of Iron Status Are Associated with Risk of Hyperuricemia among Chinese Adults: Nationwide Population-Based Study

Background: Elevated serum uric acid (SUA) involved in iron metabolism, has been increasingly recognized as a risk factor for gout and cardiovascular diseases. The objective of this study was to examine the associations between markers of iron status with risk of hyperuricemia (HU) in Chinese adult population. Methods: Data were extracted from the 2009 wave of the China Health and Nutrition Survey, consisting of 7946 apparently healthy adults. Serum ferritin (SF), transferrin, soluble transferrin receptors (sTfR), hemoglobin (Hb), high-sensitivity C-reactive protein (hs-CRP), and SUA were measured. Diet was assessed with three consecutive 24 h recalls. Demographic characteristics, smoking status, alcohol consumption, and physical activities were investigated using a structured questionnaire. Multilevel mixed-effects models were constructed to estimate the associations of SF, transferrin, sTfR, and Hb with SUA and the risk of HU. Results: The crude prevalence of HU was 16.1%. SF, transferrin, and Hb levels were positively associated with SUA and the risk of HU after adjustment for cluster effects and potential confounders (all p-trend < 0.05). Compared with participants in the lowest quartile of SF, those in the highest quartile had significantly higher SUA concentrations (β = 0.899 mg/dL, 95% confidence interval (CI): 0.788, 1.010; p < 0.001) and higher risk of HU (odds ratio (OR) = 3.086, 95% CI: 2.450, 3.888; p < 0.001). Participants with the highest quartile of transferrin had significantly higher SUA concentrations (β = 0.488 mg/dL, 95% CI: 0.389, 0.587; p < 0.001) and higher risk of HU (OR: 1.900; 95% CI: 1.579, 2.286; p < 0.001) when compared with those with the lowest quartile. In male participants, those in the highest quartile of Hb had significantly higher risk of HU when compared to the reference group (OR: 1.401, 95% CI: 1.104, 1.777; p < 0.01); however, this association was not found in female participants (OR: 1.093; 95% CI: 0.821, 1.455; p = 0.544). Conclusion: SF, transferrin, and Hb levels were positively associated with the risk of HU, and additional studies are needed to confirm the findings, as well as to elucidate their underlying mechanisms.

Prevalence and correlates of chronic kidney disease in a group of patients with hypertension in the Savanah zone of Cameroon: a cross-sectional study in Sub-Saharan Africa

BACKGROUND

The prevalence of chronic kidney disease (CKD) is increasing worldwide due to an increase in the risk factors such as hypertension. The greatest burden is in low-income settings, coupled with late diagnosis and limited management resources. This work aimed at studying the prevalence and risk factors of CKD in a group of patients with hypertension in the Savanah zone in Sub-Saharan Africa (SSA).

METHODS

We carried out a cross-sectional study between January and May 2016 in the regional Hospital of Garoua-Cameroon. Participants were adults ≥18 years of both sexes, who had a diagnosis of hypertension. Patients underwent a comprehensive clinical, biological, and electrocardiographic evaluation.

RESULTS

A total of 400 patients with hypertension were included, of whom 132 (33%; 95% CI: 28.6-37.8%) were males. Their mean age was 54.16±11.17 years. Hypertension was controlled in 122 (30.5%; 95% CI: 26.2-35.2%) participants. Twelve percent had a positive urine dipstick for proteins. The mean glomerular filtration rate (GFR) was 75.27±24.87 mL/min/1.73m2. The prevalence of CKD was seen in 129 (32.3%; 95% CI: 27.9-36.98) participants. Stage 3A was the most frequent (62.01%). The main comorbidities were anemia (44.5%), obesity (39.75%), diabetes (32%), consumption of traditional medicines (15.75%), and hyperuricemia (10.75%). After multivariate analysis, age >50 years (aOR: 1.75; 95% CI: 1.06-2.89; P=0.027), female sex (aOR: 2.21; 95% CI: 1.29-3.78; P=0.0035), obesity (aOR: 1.58, 95% CI: 1.01-2.44; P=0.026) and the hyperuricemia (aOR: 3.67; 95% CI: 1.78-7.58; P<0.001) were independently associated with CKD.

CONCLUSIONS

The prevalence of CKD in adults with hypertension was high. This was associated with age greater than 50 years, female sex, obesity and the hyperuricemia.