Preview

Медицинский алфавит

Расширенный поиск
Доступ открыт Открытый доступ  Доступ закрыт Доступ платный или только для Подписчиков

Гиперурикемия как фактор риска сердечно-сосудистых заболеваний – что нового?

https://doi.org/10.33667/2078-5631-2020-13-5-11

Полный текст:

Аннотация

Значительное количество эпидемиологических исследований продемонстрировало, что гиперурикемия в высокой степени связана с риском развития сердечно-сосудистых заболеваний, хронической болезни почек и сахарного диабета. В связи с чем необходимо повышенное внимание к мониторингу уровня мочевой кислоты в сыворотке у пациентов не только с ревматологической точки зрения, но также и в отношении снижения сердечно-сосудистого и почечного рисков. Настоящая статья посвящена обзору исследований о связи гиперурикемии с сердечно-сосудистым риском и новому консенсусу по ведению пациентов с гиперурикемией и высоким сердечно-сосудистым риском, опубликованному в декабре 2019 года группой экспертов Российского медицинского общества по артериальной гипертонии, который, помимо прочего, включает алгоритм ведения данной категории пациентов.

Об авторе

Ю. В. Жернакова
ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России
Россия

д. м. н., ученый секретарь института клинической кардиологии имени А. Л. Мясникова

г. Москва



Список литературы

1. Su P, Hong L, Zhao Y, Sun H, Li L. Relationship Between Hyperuricemia and Cardiovascular Disease Risk Factors in a Chinese Population: A Cross-Sectional Study. Med Sci Monit. 2015 Sep 12; 21: 2707–17.

2. Di Stolfo G, Mastroianno S, Potenza DR, De Luca G, d’Arienzo C, Pacilli MA, et al. Serum uric acid as a prognostic marker in the setting of advanced vascular disease: a prospective study in the elderly. J Geriatr Cardiol. 2015 Sep; 12 (5): 515–20.

3. Wu AH, Gladden JD, Ahmed M, Ahmed A, Filippatos G. Relation of serum uric acid to cardiovascular disease. Int J Cardiol. 2016 Jun 15; 213: 4–7.

4. Bryan Williams, Giuseppe Mancia, Wilko Spier ing, Enrico Agabiti Rosei, Michel Azizi, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) European Heart Journal (2018) 00, 1–98. DOI: 10.1093/eurheartj/ehy339.

5. Чазова И. Е., Жернакова Ю. В. от имени экспертов. Клинические рекомендации. Диагностика и лечение артериальной гипертонии. Системные гипертензии 2019; 16 (1): 6–31.

6. Zhu Y, Bhavik J., Pandya BJ, Choi HK. Prevalence of Gout and Hyperuricemia in the US General Population. The National Health and Nutrition Examination Survey 2007–2008. Arthritis & Rheumatism 2011; 63 (10): 3136–41.

7. Liu B, Wang T, Zhao HN et al. The prevalence of hyperuricemia in China: a meta-analysis. BMC Public Health 2011; 11: 832.

8. Qiu L, Cheng X, Wu J et al. Prevalence of hyperuricemia and its related risk factors in healthy adults from Northern and Northeastern Chinese provinces. BMC Public health 2013; 13: 664.

9. С. А. Шальнова, А. Д. Деев, Г. В. Артамонова, Д. В. Дупляков, А. Ю. Ефанов, Ю. В. Жернакова и др. Гиперурикемия и ее корреляты в российской популяции (результаты эпидемиологического исследования ЭССЕ-РФ). Рациональная Фар макотерапия в Кардиологии 2014; 10 (2): 153–159.

10. Hou L, Zhang M, Han W, Tang Y, Xue F, Liang S, et al. Influence of Salt Intake on Association of Blood Uric Acid with Hypertension and Related Cardiovascular Risk. PLoS One. 2016 Apr 4; 11 (4): e0150451.

11. Leiba A, Vinker S, Dinour D, Holtzman EJ, Shani M. Uric acid levels within the normal range predict increased risk of hypertension: a cohort study. J Am Soc Hypertens. 2015 Aug; 9 (8): 600–9.

12. Ando K, Takahashi H, Watanabe T, Daidoji H, Otaki Y, Nishiyama S, et al. Impact of Serum Uric Acid Levels on Coronary Plaque Stability Evaluated Using Integrated Backscatter Intravascular Ultrasound in Patients with Coronary Artery Disease. J Atheroscler Thromb. 2016 Aug 1; 23 (8): 932–9.

13. Dai XM, Wei L, Ma LL, Chen HY, Zhang ZJ, Ji ZF, et al. Serum uric acid and its relationship with cardiovascular risk profile in Chinese patients with early-onset coronary artery disease. Clin Rheumatol. 2015 Sep; 34 (9): 1605–11.

14. de Oliveira EP, Burini RC. High plasma uric acid concentration: causes and consequences. Diabetol Metab Syndr. 2012; 4: 12. DOI: 10.1186/1758–59964–12, indexed in Pubmed: 22475652.

15. Leyva F., Anker S., Swan J. W. et al. Serum uric acid as an index of impaired oxidative metabolism in chronic heart failure. Eur Heart J 1997; 18: 5: 858–865.

16. Staub M. Uric acid as a scavenger in oxidative stress. Orv Hetil 1999; 140: 6: 275–279.

17. Ames B. N., Cathcart R., Schwiers E., Hochstein P. Uric acid provides an antioxidant defense in humans against oxidant – and radical-caused aging and cancer: a hypothesis. Proc Natl Acad Sci USA 1981; 78: 6858–6862.

18. Tomita М., Mizuno S., Yamanaka H. et al. Does hyperuricemia affect mortality? A prospective cohort study of Japanese male workers. J Epidemiol 2000; 10: 6: 403–409.

19. Agudelo C. A., Wise C. M. Gout: diagnosis, pathogenesis, and clinical manifestations. Curr Opin Rheumatol 2001; 13: 3: 234–239.

20. Niskanen L. K., Laaksonen D. E., Nyyssonen K. et al. Uric acid level as a risk factor for cardiovascular and all–cause mortality in middle–aged men: a prospective cohort study. Arch Intern Med 2004; 164: 1546.

21. Mazzali M., Kanellis J., Han L. Et al. Hyperuricemia inducesa primary arteriolopathy in rats by a blood pressure–independent mechanism. Am J Physiol 2002; 282: F991–F997.

22. Choi H, Kim HC, Song BM, Park JH, Lee JM, Yoon DL, et al. Serum uric acid concentration and metabolic syndrome among elderly Koreans: The Korean Urban Rural Elderly (KURE) study. Arch Gerontol Geriatr. 2016. May-Jun; 64: 51–8.

23. Prasad M, Matteson EL, Herrmann J, et al. Uric acid is associated with inflammation, coronary microvascular dysfunction, and adverse outcomes in postmenopausal women. Hypertension. 2017; 69 (2): 236–242, DOI: 10.1161/HYPERTENSIONAHA.116.08436, indexed in Pubmed: 27993955.

24. Farquharson CA, et al. Allopurinol improves endothelial dysfunction in chronic heart failure. Circulation. 2002; 106 (2): 221–226.

25. Watanabe S, Kang DH, Feng L, et al. Uric acid, hominoid evolution, and the pathogenesis of salt-sensitivity. Hypertension. 2002; 40 (3): 355–360, indexed in Pubmed: 12215479.

26. Lin C, Zhang Pu, Xue Y, et al. Link of renal microcirculatory dysfunction to increased coronary microcirculatory resistance in hypertensive patients. Cardiol J. 2017; 24 (6): 623–632, DOI: 10.5603/CJ.a2017.0074, indexed in Pubmed: 28653312.

27. Mazzali M, Hughes J, Kim YG, et al. Elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism. Hyperten sion. 2001; 38 (5): 1101–1106, indexed in Pubmed: 11711505.

28. Kang DH, Park SK, Lee IK, et al. Uric acid-induced C-reactive protein expression: implication on cell proliferation and nitric oxide production of human vascular cells. J Am Soc Nephrol. 2005; 16 (12): 3553–3562, DOI: 10.1681/ASN.2005050572, indexed in Pubmed: 16251237.

29. Corry DB, Eslami P, Yamamoto K, et al. Uric acid stimulates vascular smooth muscle cell proliferation and oxidative stress via the vascular renin-angiotensin system. J Hypertens. 2008; 26 (2): 269–275, DOI: 10.1097/HJH.0b013e3282f240bf, indexed in Pubmed: 18192841.

30. Kang DH, Han L, Ouyang X, et al. Uric acid causes vascular smooth muscle cell proliferation by entering cells via a functional urate transport er. Am J Nephrol. 2005; 25 (5): 425–433, DOI: 10.1159/000087713, indexed in Pubmed: 16113518.

31. Feig DI, Nakagawa T, Karumanchi SA, et al. Hypothesis: Uric acid, nephron number, and the pathogenesis of essential hypertension. Kidney Int. 2004; 66 (1): 281–287, DOI: 10.1111/j.1523–1755.2004.00729.x, indexed in Pubmed: 15200435.

32. Lee JE, Kim YG, Choi YH, et al. Serum uric acid is associated with microalbuminuria in prehypertension. Hypertension. 2006; 47 (5): 962–967, DOI: 10.1161/01.HYP.0000210550.97398.c2, indexed in Pubmed: 16520402.

33. Iseki K, Oshiro S, Tozawa M, et al. Significance of hyperuricemia on the early detection of renal failure in a cohort of screened subjects. Hypertens Res. 2001; 24 (6): 691–697, indexed in Pubmed: 11768729.

34. Rosolowsky ET, Ficociello LH, Maselli NJ, et al. High-normal serum uric acid is associated with impaired glomerular filtration rate in nonproteinuric patients with type 1 diabetes. Clin J Am Soc Nephrol. 2008; 3 (3): 706–713, DOI: 10.2215/CJN.04271007, indexed in Pubmed: 18272826.

35. Furukawa S, Fujita T, Shimabukuro M, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest. 2004; 114 (12): 1752–1761, DOI: 10.1172/JCI21625, indexed in Pubmed: 15599400.

36. Fabbrini E, Serafini M, Baric IC, et al. Effect of plasma uric acid on antioxidant capacity, oxidative stress, and insulin sensitivity in obese subjects. Diabetes. 2014; 63 (3): 976–981, DOI: 10.2337/db13–1396.

37. Grassi D, Desideri G, Giacomantonio ADi, et al. Hyperuricemia and cardiovascular risk. High Blood Press Cardiovasc Prev. 2014; 21 (4): 235–242, DOI: 10.1007/s40292–014–0046–3.

38. Neogi T, Jansen TLTA, Dalbeth N, et al. ACR/EULAR CLassification Criteria for Gout. ARTHRITIS Rheumatol. 2015; 67 (10): 2557–2568. doi:10.1002/art.39254.

39. Yan D, Wang J, Jiang F, et al. A causal relationship between uric acid and diabetic macrovascular disease in Chinese type 2 diabetes patients: A Mendelian randomization analysis. Int J Cardiol. 2016; 214: 194–199, DOI: 10.1016/j.ijcard.2016.03.206, indexed in Pubmed: 27064641.

40. Kuwabara M, Borghi C, Cicero AFG, et al. Elevated serum uric acid increases risks for developing high LDL cholesterol and hypertriglyceridemia: A five-year cohort study in Japan. Int J Cardiol. 2018; 261: 183–188, DOI: 10.1016/j.ijcard.2018.03.045, indexed in Pubmed: 29551256.

41. Borghi C, Desideri G. Urate-Lowering drugs and prevention of cardiovascular disease: the emerging role of xanthine oxidase inhibition. Hypertension. 2016; 67 (3): 496–498, DOI: 10.1161/HYPERTENSIONAHA.115.06531, indexed in Pubmed: 26865197.

42. Bove M, Cicero AF, Veronesi M, et al. An evi dence-based review on urate-lowering treatments: implications for optimal treatment of chronic hyperuricemia. Vasc Health Risk Manag. 2017; 13: 23–28.

43. Ford ES, Li C, Cook S, et al. Serum concentrations of uric acid and the metabolic syndrome among US children and adolescents. Circulation. 2007; 115 (19): 2526–2532, DOI: 10.1161/CIRCULATIONAHA.106.657627, indexed in Pubmed: 17470699.

44. Puig JG, Martínez MA. Hyperuricemia, gout and the metabolic syndrome. Curr Opin Rheumatol. 2008; 20 (2): 187–191, DOI: 10.1097/BOR.0b013e3282f4b1ed, indexed in Pubmed: 18349749.

45. Tuttle KR, Short RA, Johnson RJ. Sex differences in uric acid and risk factors for coronary artery disease. Am J Cardiol. 2001; 87 (12): 1411–1414, indexed in Pubmed: 11397367.

46. Yü TF, Berger L, Dorph DJ, et al. Renal function in gout. V. Factors influencing the renal hemody namics. Am J Med. 1979; 67 (5): 766–771, indexed in Pubmed: 507087.

47. Dehghan A, van Hoek M, Sijbrands EJG, et al. High serum uric acid as a novel risk factor for type 2 diabetes. Diabetes Care. 2008; 31 (2): 361–362, DOI: 10.2337/dc07–1276, indexed in Pubmed: 17977935.

48. Alper AB, Chen W, Yau L, et al. Childhood uric acid predicts adult blood pressure: the Bogalusa Heart Study. Hypertension. 2005; 45 (1): 34–38, DOI: 10.1161/01.HYP.0000150783.79172.bb, indexed in Pubmed: 15569853.

49. Dyer AR, Liu K, Walsh M, et al. Ten-year incidence of elevated blood pressure and its predictors: the CARDIA study. Coronary Artery Risk Development in (Young) Adults. J Hum Hypertens. 1999; 13 (1): 13–21, indexed in Pubmed: 9928747.

50. Forman JP, Choi H, Curhan GC. Plasma uric acid level and risk for incident hypertension among men. J Am Soc Nephrol. 2007; 18 (1): 287–292, DOI: 10.1681/ASN.2006080865, indexed in Pubmed: 17167112.

51. Hunt SC, Stephenson SH, Hopkins PN, et al. Predictors of an increased risk of future hypertension in Utah. A screening analysis. Hypertension. 1991; 17 (6 pt 2): 969–976, DOI: 10.1161/01.hyp.17.6.969.

52. Imazu M, Yamamoto H, Toyofuku M, et al. Hyperinsulinemia for the development of hypertension: data from the Hawaii-Los Angeles-Hiroshima Study. Hypertens Res. 2001; 24 (5): 531–536, indexed in Pubmed: 11675947.

53. Jossa F, Farinaro E, Panico S, et al. Serum uric acid and hypertension: the Olivetti heart study. J Hum Hypertens. 1994; 8 (9): 677–681, indexed in Pubmed: 7807497.

54. Krishnan E, Kwoh CK, Schumacher HR, et al. Hyperuricemia and incidence of hypertension among men without metabolic syndrome. Hypertension. 2007; 49 (2): 298–303, DOI: 10.1161/01.HYP.0000254480.64564. b6, indexed in Pubmed: 17190877.

55. Masuo K, Kawaguchi H, Mikami H, et al. Serum uric acid and plasma norepinephrine concentrations predict subsequent weight gain and blood pressure elevation. Hypertension. 2003; 42 (4): 474–480, DOI: 10.1161/01.HYP.0000091371.53502.D 3, indexed in Pubmed: 12953019.

56. Mellen P, Bleyer A, Erlinger T, et al. Serum Uric Acid Predicts Incident Hypertension in a Biethnic Cohort. Hypertension. 2006; 48 (6): 1037–1042, DOI: 10.1161/01.hyp.0000249768.26560.66.

57. Nagahama K, Inoue T, Iseki K, et al. Hyperuricemia as a predictor of hypertension in a screened cohort in Okinawa, Japan. Hypertension Res. 2004; 27 (11): 835–841, DOI: 10.1291/hypres.27.835.

58. Taniguchi Y, Hayashi T, Tsumura K, et al. Serum uric acid and the risk for hypertension and Type 2 diabetes in Japanese men: The Osaka Health Survey. J Hypertens. 2001; 19 (7): 1209–1215, indexed in Pubmed: 11446710.

59. Kang DH, Nakagawa T, Feng L, et al. A role for uric acid in the progression of renal disease. J Am Soc Nephrol. 2002; 13 (12): 2888–2897, indexed in Pubmed: 12444207.

60. Syamala S, Li J, Shankar A. Association between serum uric acid and prehypertension among US adults. J Hypertens. 2007; 25 (8): 1583–1589, DOI: 10.1097/HJH.0b013e32813aeb6c, indexed in Pubmed: 17620953.

61. Nagahama K, Inoue T, Iseki K, et al. Hyperuricemia as a predictor of hypertension in a screened cohort in Okinawa, Japan. Hypertension Res. 2004; 27 (11): 835–841, DOI: 10.1291/hypres.27.835.

62. Grayson PC, Kim SY, LaValley M, et al. Hyperuricemia and incident hypertension: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2011; 63 (1): 102–110, DOI: 10.1002/acr.20344, indexed in Pubmed: 20824805.

63. Bombelli M, Ronchi I, Volpe M, et al. Prognostic value of serum uric acid: new-onset in and out-of-office hypertension and long-term mortality. J Hypertens. 2014; 32 (6): 1237–1244, DOI: 10.1097/HJH.0000000000000161, indexed in Pubmed: 24675682.

64. Perlstein TS, Gumieniak O, Williams GH, et al. Uric acid and the development of hypertension: the normative aging study. Hypertension. 2006; 48 (6): 10311036, DOI: 10.1161/01.HYP.0000248752.08807.4c, indexed in Pubmed: 17060508.

65. Forman JP, Choi H, Curhan GC. Uric acid and insulin sensitivity and risk of incident hypertension. Arch Intern Med. 2009; 169 (2): 155–162, DOI: 10.1001/archinternmed.2008.521, indexed in Pubmed: 19171812.

66. Zhang W, Sun K, Yang Y, et al. Plasma uric acid and hypertension in a Chinese community: prospective study and metaanalysis. Clin Chem. 2009; 55 (11): 2026–2034, DOI: 10.1373/clinchem.2009.124891, indexed in Pubmed: 19729471.

67. Shankar A, Klein R, Klein BEK, et al. The association between serum uric acid level and long-term incidence of hypertension: Population-based cohort study. J Hum Hypertens. 2006; 20 (12): 937–945, DOI: 10.1038/sj.jhh.1002095, indexed in Pubmed: 17024135.

68. Sundström J, Sullivan L, D’Agostino RB, et al. Relations of serum uric acid to longitudinal blood pressure tracking and hypertension incidence. Hypertension. 2005; 45 (1): 28–33, DOI: 10.1161/01.

69. Bombelli M, Ronchi I, Volpe M, et al. Prognostic value of serum uric acid: new-onset in and out-of-office hypertension and long-term mortality. J Hypertens. 2014; 32 (6): 1237–1244, DOI: 10.1097/HJH.0000000000000161, indexed in Pubmed: 24675682.

70. Stack AG, Hanley A, Casserly LF, et al. Independent and conjoint associations of gout and hyperuricaemia with total and cardiovascular mortality. QJM. 2013; 106 (7): 647–658, DOI: 10.1093/qjmed/hct083, indexed in Pubmed: 23564632.

71. Krishnan E, Pandya BJ, Lingala B, et al. Hyperuricemia and untreated gout are poor prognostic markers among those with a recent acute myocardial infarction. Arthritis Res Ther. 2012; 14 (1): R 10, DOI: 10.1186/ar3684, indexed in Pubmed: 22251426.

72. Holme I, Aastveit AH, Hammar N, et al. Uric acid and risk of myocardial infarction, stroke and congestive heart failure in 417,734 men and women in the Apolipoprotein MOrtality RISk study (AMORIS). J Intern Med. 2009; 266 (6): 558–570, DOI: 10.1111/j.1365–2796.2009.02133.x, indexed in Pubmed: 19563390.

73. Crosta F, Occhiuzzi U, Passalacqua G, et al. Association Between the Serum Uric Acid Levels and Lacunar Infarcts in the Elderly. J Mol Neurosci. 2018; 65 (3): 385–390, DOI: 10.1007/s12031–018–1096–0, indexed in Pubmed: 29974380.

74. Чазова И. Е., Жернакова Ю. В., Кисляк О. А., Недогода С. В., Подзолков В. И., Ощепкова Е. В., Медведева И. В., Миронова О. Ю., Блинова Н. В. Консенсус по ведению пациентов с гиперурикемией и высоким сердечно-сосудистым риском. Системные гипертензии. 2019; 16 (4): 8–21.

75. Fotherby MD, Potter JF. Metabolic and orthostatic blood pressure responses to a low-sodium diet in elderly hypertensives. J Hum Hypertens. 1997; 11 (6): 361–366, indexed in Pubmed: 9249230.

76. Singh JA, Reddy SG, Kundukulam J. Risk factors for gout and prevention: a systematic review of the literature. Curr Opin Rheumatol. 2011; 23 (2): 192–202, DOI: 10.1097/BOR.0b013e3283438e13, indexed in Pubmed: 21285714.

77. Matsumura K, Arima H, Tominaga M, et al. Effect of losartan on serum uric acid in hypertension treated with a diuretic: the COMFORT study. Clin Exp Hypertens. 2015; 37 (3): 192–196, DOI: 10.3109/10641963.2014.933968, indexed in Pubmed: 25051056.

78. Jacob RA, Spinozzi GM, Simon VA, et al. Consumption of cherries lowers plasma urate in healthy women. J Nutr. 2003; 133 (6): 1826–1829, DOI: 10.1093/jn/133.6.1826, indexed in Pubmed: 12771324.

79. Schlesinger N. Dietary factors and hyperuricaemia. Curr Pharm Des. 2005; 11 (32): 4133–4138, indexed in Pubmed: 16375734.

80. White WB, Saag KG, Becker MA, et al. CARES Investigators. Cardiovascular safety of febuxostat or allopurinol in patients with gout. N Engl J Med. 2018; 378 (13): 1200–1210, DOI: 10.1056/NEJMoa1710895, indexed in Pubmed: 29527974.

81. Richette P, Perez-Ruiz F, Doherty M, et al. Improving cardiovascular and renal outcomes in gout: what should we target? Nat Rev Rheumatol. 2014; 10 (11): 654–661, DOI: 10.1038/nrrheum.2014.124, indexed in Pubmed: 25136785.

82. Okafor ON, Farrington K, Gorog DA. Allopurinol as a therapeutic option in cardiovascular disease. Pharmacol Ther. 2017; 172: 139–150, DOI: 10.1016/j.pharmthera.2016.12.004, indexed in Pubmed: 27916655.

83. Pacher P, Nivorozhkin A, Szabó C. Therapeutic effects of xanthine oxidase inhibitors: renaissance half a century after the discovery of allopurinol. Pharmacol Rev. 2006; 58 (1): 87–114, DOI: 10.1124/pr.58.1.6, indexed in Pubmed: 16507884.

84. Thanassoulis G, Brophy JM, Richard H, et al. Gout, allopurinol use, and heart failure outcomes. Arch Intern Med. 2010; 170 (15): 1358–1364, DOI: 10.1001/archinternmed.2010.198, indexed in Pubmed: 20696962.

85. Инструкция по медицинскому применению лекарственного препарата Милурит, регистр. удостоверение П N 012684/01 06.11.19.

86. Spinar J, Vítovec J, Soucek M, Dusek L, Pavlík T. Comparsion of Recommended Doses of ACE inhibitors and angiotensin II receptor blockers. Vnitr Lek. 2009 May; 55 (5): 481–8.


Для цитирования:


Жернакова Ю.В. Гиперурикемия как фактор риска сердечно-сосудистых заболеваний – что нового? Медицинский алфавит. 2020;(13):5-11. https://doi.org/10.33667/2078-5631-2020-13-5-11

For citation:


Zhernakova Yu.V. Hyperuricemia as risk factor for cardiovascular disease – what’s new? Medical alphabet. 2020;(13):5-11. (In Russ.) https://doi.org/10.33667/2078-5631-2020-13-5-11

Просмотров: 98


ISSN 2078-5631 (Print)