A vasodilating β1 blocker celiprolol inhibits muscular release of uric acid precursor in patients with essential hypertension

Survey on uric acid in Chinese subjects with essential hypertension (SUCCESS): a nationwide cross-sectional study

Background

Hyperuricemia (HUA) is associated with hypertension and increased cardiovascular risk. Current data regarding the prevalence of HUA in Chinese hypertensive patients are lacking. Our study aims to explore the prevalence and determinants of HUA in Chinese hypertensive adults.

Methods

Treatment-naive hypertensive adults or those taking single antihypertensive agent were included in a nationwide cross-sectional study. Basic demographics, antihypertensive medications, serum uric acid (UA), and other parameters were documented.

Results

The overall prevalence rate of HUA was 38.7% among 33,785 valid cases, 35.1% for males (UA >420 µmol/L), and 45.2% for females (UA >360 µmol/L). A multiple logistic regression analysis, adjusted for demographic and clinical factors (model 1), revealed that female sex [odds ratio (OR), 95% CI, 1.43, 1.36–1.51], age of ≥65 years (1.12, 1.05–1.19), low evaluated glomerular filtration rate [eGFR; 2.06, 1.91–2.23, the lowest [Q1] vs. the highest quartile (Q4)], unmarried (1.58, 1.10–2.27), Western China residency (3.21, 3.33–3.91), longer hypertension duration (1.97, 1.78–2.12, Q4 vs. Q1) and aspirin use (1.21, 1.14–1.29) were associated with HUA. In a multiple logistic regression analysis adjusted for clinical and metabolic parameters (model 2), female sex (OR, 95% CI, 1.34, 1.27–1.41), age of ≥65 years (1.09, 1.03–1.16), low eGFR (2.35, 2.19–2.52, Q1 vs. Q4), new–onset hypertension (2.01, 1.73–2.33), higher quartile of fasting blood glucose (FBG), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) levels, and body mass index (BMI) were associated with higher risk of HUA (1.89, 1.76–2.03; 2.15, 1.99–2.31; 2.86, 2.67–3.06; 1.27, 1.27–1.36, respectively, Q4 vs. Q1). Losartan, valsartan, and nifedipine were associated with lower risk of HUA (OR, 95% CI, 0.77, 0.67–0.88, 0.68, 0.60–0.77; 0.87, 0.77–0.99, 0.79, 0.70–0.89 and 0.80, 0.70–0.91, 0.82, 0.72–0.92), respectively, in models 1 and 2.

Conclusions

The prevalence rate of HUA in Chinese hypertensive patients was 38.7%. Female sex, aging (≥65 years), and low eGFR were independent predictors of HUA. HUA was lower among the patients who were taking losartan, valsartan, and nifedipine. Western region residents, new-onset hypertension, longer hypertension duration, aspirin use, higher FBG, TG, LDL-C levels and BMI were potential risk factors for HUA.

Active Acupoints Differ from Inactive Acupoints in Modulating Key Plasmatic Metabolites of Hypertension: A Targeted Metabolomics Study

The effect of active acupoints versus inactive acupoints in treating hypertension is not well documented. Metabolic phenotypes, depicted by metabolomics analysis, reflect the influence of external exposures, nutrition, and lifestyle on the integrated system of the human body. Therefore, we utilized high-performance liquid chromatography tandem mass spectrometry to compare the targeted metabolic phenotype changes induced by two different acupoint treatments. The clinical outcomes show that active acupoint treatment significantly lowers 24-hour systolic blood pressure but not diastolic blood pressure, as compared with inactive acupoint treatment. Furthermore, distinctive changes are observed between the metabolomics data of the two groups. Multivariate analysis shows that only in the active acupoint treatment group can the follow-up plasma be clearly separated from the baseline plasma. Moreover, the follow-up plasma of these two groups can be clearly separated, indicating two different post-treatment metabolic phenotypes. Three metabolites, sucrose, cellobiose, and hypoxanthine, are shown to be the most important features of active acupoint treatment. This study demonstrates that metabolomic analysis is a potential tool that can be used to efficiently differentiate the effect of active acupoints from inactive acupoints in treating hypertension. Possible mechanisms are the alternation of hypothalamic microinflammation and the restoration of host-gut microbiota interactions induced by acupuncture.