Association of serum uric acid levels with blood pressure and the incidence of hypertension in the middle-aged and elderly populations

Objective:This study aimed to investigate the relationship between serum uric acid (SUA) levels and hypertension in the middle-aged and elderly populations.Methods:The cross-sectional analysis included 13349 middle-aged and elderly general health checkup examinees without cardiovascular disease. The retrospective cohort analysis included 6659 normotensive participants (mean age: 64.6years). Participants were divided into three groups based on their SBP/DBP levels: normal (<120/<80mmHg), high normal (120-129/<80mmHg), and elevated (130-139/80-89mmHg), and were classified into three groups based on the results of 75g oral glucose tolerance test: normoglycemia, prediabetes, and diabetes.Results:SUA levels were significantly associated with SBP and DBP in this cross-sectional study. Over a mean 6.5-year follow-up period, 2038 participants developed hypertension. According to the SUA quartiles, the incidence of hypertension increased [26.1% in quartile (Q1) (4.1mg/dl), 28.6% in Q2 (4.2-4.9mg/dl), 32.6% in Q3 (5.0-5.8mg/dl), 34.9% in Q4 (>= 5.9mg/dl); P for trend <0.001]. In multivariable analyses, SUA levels were positively associated with hypertension incidence only in the normal BP group [Q4 vs. Q1 odds ratio (OR): 1.64, 95% confidence intervals (CIs): 1.11-2.44; Q3 vs. Q1 OR: 1.69, 95% CI: 1.19-2.42] and in the normoglycemic group (Q4 vs. Q1 OR: 1.34, 95% CI: 1.02-1.76; Q3 vs. Q1 OR: 1.36, 95% CI: 1.07-1.74).Conclusion:In the middle-aged and elderly populations, normotensive or normoglycemic individuals with SUA levels at least 5mg/dl may be potential targets for SUA management to prevent hypertension.