Hyperuricemia and coronary heart disease: A systematic review and meta‐analysis
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Open Access
- 8 January 2010
- journal article
- research article
- Published by Wiley in Arthritis Care & Research
- Vol. 62 (2), 170-180
- https://doi.org/10.1002/acr.20065
Abstract
Objective The role of serum uric acid as an independent risk factor for cardiovascular disease remains unclear, although hyperuricemia is associated with cardiovascular disease such as coronary heart disease (CHD), stroke, and hypertension. Methods A systematic review and meta‐analysis using a random‐effects model was conducted to determine the risk of CHD associated with hyperuricemia in adults. Studies of hyperuricemia and CHD were identified by searching major electronic databases using the medical subject headings and keywords without language restriction (through February 2009). Only prospective cohort studies were included if they had data on CHD incidences or mortalities related to serum uric acid levels in adults. Results Twenty‐six eligible studies of 402,997 adults were identified. Hyperuricemia was associated with an increased risk of CHD incidence (unadjusted risk ratio [RR] 1.34, 95% confidence interval [95% CI] 1.19–1.49) and mortality (unadjusted RR 1.46, 95% CI 1.20–1.73). When adjusted for potential confounding, the pooled RR was 1.09 (95% CI 1.03–1.16) for CHD incidence and 1.16 (95% CI 1.01–1.30) for CHD mortality. For each increase of 1 mg/dl in uric acid level, the pooled multivariate RR for CHD mortality was 1.12 (95% CI 1.05–1.19). Subgroup analyses showed no significant association between hyperuricemia and CHD incidence/mortality in men, but an increased risk for CHD mortality in women (RR 1.67, 95% CI 1.30–2.04). Conclusion Hyperuricemia may marginally increase the risk of CHD events, independently of traditional CHD risk factors. A more pronounced increased risk for CHD mortality in women should be investigated in future research.Keywords
This publication has 72 references indexed in Scilit:
- Hyperuricemia and risk of stroke: A systematic review and meta‐analysisArthritis Care & Research, 2009
- Serum uric acid level as an independent risk factor for all‐cause, cardiovascular, and ischemic stroke mortality: A chinese cohort studyArthritis Care & Research, 2009
- Association of Incident Gout and Mortality in Dialysis PatientsJournal of the American Society of Nephrology, 2008
- Uric Acid and Cardiovascular RiskThe New England Journal of Medicine, 2008
- Effect of Allopurinol on Blood Pressure of Adolescents With Newly Diagnosed Essential HypertensionJAMA, 2008
- Serum Uric Acid and Coronary Heart Disease in 9,458 Incident Cases and 155,084 Controls: Prospective Study and Meta-AnalysisPLoS Medicine, 2005
- Quantifying heterogeneity in a meta-analysisStatistics in Medicine, 2002
- Meta-analysis in clinical trialsControlled Clinical Trials, 1986
- Uric acid provides an antioxidant defense in humans against oxidant- and radical-caused aging and cancer: a hypothesis.Proceedings of the National Academy of Sciences of the United States of America, 1981
- Uric acid: a risk factor for coronary heart disease?Circulation, 1979