Serum uric acid in hypertensive patients with and without peripheral arterial disease

Atherosclerosis. 2003 May;168(1):163-8. doi: 10.1016/s0021-9150(03)00093-5.


Background: Uric acid is frequently elevated in hypertension. In addition to renal and metabolic disturbances, lower limb ischemia might contribute to hyperuricemia among hypertensives complicated by peripheral arterial disease (PAD).

Objective: To test the hypothesis that uric acid status is related to lower limb function in hypertensives with PAD.

Methods: Serum and 24-h urine uric acid levels and other risk factors were examined in 145 hypertensives free of PAD and 166 hypertensives with PAD. Ankle/brachial index (ABI) and absolute claudication distance (in PAD) on a treadmill test (ACD) were assessed.

Results: In multiple regression analysis for serum uric acid in the total group, PAD emerged as an independent determinant (P=0.03) next to age (P=0.005), triglycerides (P=0.04), and insulin (P=0.02). Serum uric acid concentrations were higher in hypertensives with PAD (404+/-101 vs. 347+/-80 micromol/l, P<0.001) independent of components of the metabolic syndrome (body mass index, triglycerides, insulin) and of age, gender, diabetes mellitus, pulse pressure, cholesterol, C-reactive protein, and treatment. After adjustment for kidney function by uric acid/creatinine ratio, values remained higher in hypertensives with PAD (P=0.01). Uric acid excretion was higher in the PAD group (P<0.001), whereas uric acid clearance was comparable between both groups. In multiple regression analysis for ACD (357+/-183 m) in the PAD group, serum uric acid (P=0.02), C-reactive protein (P<0.0001), age (P=0.02), and smoking (P=0.004) were independently associated. ABI (0.62+/-0.17) was not related to uric acid in PAD patients.

Conclusion: Hyperuricemia is more pronounced in hypertensives complicated by PAD and is associated with worse functional status of the peripheral circulation.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Belgium / epidemiology
  • Biomarkers / blood
  • Biomarkers / urine
  • Blood Glucose / metabolism
  • Blood Pressure / physiology
  • Body Mass Index
  • C-Reactive Protein / metabolism
  • Cholesterol, HDL / metabolism
  • Creatinine / blood
  • Exercise Test
  • Fasting / metabolism
  • Female
  • Humans
  • Hypertension / blood*
  • Hypertension / epidemiology
  • Insulin / blood
  • Intermittent Claudication / blood
  • Intermittent Claudication / epidemiology
  • Lower Extremity / blood supply
  • Male
  • Middle Aged
  • Peripheral Vascular Diseases / blood*
  • Peripheral Vascular Diseases / epidemiology
  • Risk Factors
  • Statistics as Topic
  • Triglycerides / metabolism
  • Uric Acid / blood*
  • Uric Acid / urine


  • Biomarkers
  • Blood Glucose
  • Cholesterol, HDL
  • Insulin
  • Triglycerides
  • Uric Acid
  • C-Reactive Protein
  • Creatinine