Interrelationship of Serum Uric Acid Levels and Cardiovascular Disease Risk Factors in Bangladeshi Patients Treated with Antihypertensive Drugs

Aims: To explore the association between serum uric acid levels and cardiovascular disease (CVD) risk factors in hypertensive subjects treated with (WD) or without lipid-lowering and antihypertensive drugs (WOD).

Study Design: Three groups of subjects with age range 50-70 y were included in the investigation: i) Normotensive healthy control subjects; ii) hypertensive subjects who did not start ‘taking’ lipid-lowering-/antihypertensive drugs and had cardiovascular-risk factors such as high blood pressure and high blood cholesterol; and iii) hypertensive subjects, who were already on lipid-lowering-/antihypertensive drugs at least for 3-months.

Place and Duration of Study: Dept. of Biochemistry & Molecular Biology, University of Dhaka, Jahangirnagar University and Tejgaon college; Dhaka Medical College Hospital and Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, between April 2014 and May 2015.

Methods: We included 197 subjects ((40 controls, 59 hypertensive subjects without drugs (WOD) and 98 subjects with drugs (WD)). Anthropometric as well as measurements blood pressure, weight/height and laboratory tests, such as lipid profile, electrolytes, zinc, uric were done.

Results: The hypertensive subjects without drugs (WOD) had significantly (P<.05) higher levels of CVD risk factors, including blood pressure, serum Total cholesterol (TC) and uric acid (UA) [Hypertensive WOD vs. Control subjects: SBP: 169±1.30 vs. 125±2.75 and DBP: 92.3±1.50 vs. 78.5±1.50 mmHg; TC: 378±9.60 vs. 176±3.20 mg/dL; UA: 12.0±0.10 vs. 4.10±0.20 mg/dL). Antihypertensive drugs significantly (P<.05) ameliorated the blood pressure, TC, HDL-C levels, LDL-C/HDL-C and TG/HDL-C ratios. Multiple regression analysis showed serum uric acid levels were positively but independently correlated with LDL-C.

Conclusion: Elevated serum uric acid and LDL-C levels were positively correlated independently of other measured confounders such as body mass index, high blood pressure, triacyglycerol/total cholesterol, electrolytes and zinc. Our results suggest that corrective measures to control hyperuricemia might be one of the approaches to manage damaging effects of uric acid on cardiovascular diseases during hypertension. These predictors, however, need further work to validate reliability on a large number of sample sizes.