Uric Acid and Insulin Sensitivity and Risk of Incident Hypertension

Abstract

Hypertension is highly prevalent, affecting approximately one-third of Americans,¹ and is a leading cause of morbidity and mortality.² The etiology of hypertension is unclear in most patients.³ Proposed pathophysiologic mechanisms include (1) uric acid–induced activation of the renin-angiotensin system and injury to preglomerular renal vessels,⁴ (2) reduced insulin sensitivity and hyperinsulinemia with altered renal sodium handling and enhanced sympathetic tone,^5-7 and (3) endothelial dysfunction with altered vascular tone and function.^8-11 Measurement of these potential pathophysiologic factors may ultimately lead to identification of high-risk individuals and improved prevention.