Asymptomatic hyperuricemia and incident congestive heart failure in elderly patients without comorbidities

Nutr Metab Cardiovasc Dis. 2020 Apr 12;30(4):666-673. doi: 10.1016/j.numecd.2019.12.008. Epub 2019 Dec 23.

Abstract

Background and aims: Although hyperuricemia is associated with congestive heart failure (CHF), hyperuricemic patients frequently have other comorbidities. Thus, it is difficult to distinguish the role of hyperuricemia from that of other comorbid conditions in CHF. The aim of this study was to evaluate the association between hyperuricemia and CHF in elderly patients without comorbidities.

Methods and results: Subjects aged ≥65 years were analyzed at enrollment (2009-2012) and during the 4-year follow-up period at the Kangjian Community Health Center of Shanghai. Subjects were excluded if they had hypertension, diabetes mellitus, preexisting cardiovascular disease, hyperlipidemia, overweight or obesity, a history of gout or hyperuricemia and were taking medication for their condition, or chronic kidney disease. The primary outcome of this study was to investigate the impact of asymptomatic hyperuricemia on incident CHF. We used Cox regression to estimate the hazard ratio (HR) for incident CHF events between hyperuricemic (defined as an SUA level >7 mg/dL in men and ≥6 mg/dL in women) and normouricemic subjects. A total of 2749 subjects (70.9 ± 6.0 years) were followed for 47.4 ± 3.6 months. Asymptomatic hyperuricemia was associated with an increased cumulative incidence of incident CHF events (6.5% versus 3.1%, odds ratio [OR] = 2.15, 95% confidence index [CI]: 1.39-3.33, p = 0.001). After adjusting for confounding factors, including baseline eGFR, hyperuricemia independently predicted the risk of incident CHF events (HR = 2.34, 95% CI: 1.50-3.63, p < 0.001).

Conclusion: Asymptomatic hyperuricemia was a valuable biomarker for predicting the development of incident CHF in elderly patients without comorbidities.

Keywords: Congestive heart failure; Elderly; Hyperuricemia.

Publication types

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

MeSH terms

  • Age Factors
  • Aged
  • Asymptomatic Diseases
  • Biomarkers / blood
  • China / epidemiology
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / epidemiology*
  • Heart Failure / physiopathology
  • Humans
  • Hyperuricemia / blood
  • Hyperuricemia / diagnosis
  • Hyperuricemia / epidemiology*
  • Incidence
  • Longitudinal Studies
  • Male
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Uric Acid / blood*

Substances

  • Biomarkers
  • Uric Acid