Elevated uric acid and obesity-related cardiovascular disease risk factors among hypertensive youth

Lauren D. Reschke, Edgar R. Miller, Jeffrey J. Fadrowski, Lauren F. Loeffler, Kathryn Holmes, Lawrence J. Appel, Tammy M. Brady

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Uric acid (UA) is associated with high blood pressure in adolescents and with left ventricular hypertrophy (LVH) and cardiovascular disease (CVD) in adults. We sought to determine if UA is independently associated with CVD risk factors and left ventricular mass (LVM) over time in hypertensive youth. Methods: This was a 1-year prospective observational study of hypertensive children aged 3–19 years. Cross-sectional and longitudinal associations of serum UA with CVD risk factors and LVM were explored. Results: Of the 49 children who completed both the baseline and 12-month assessments, at baseline the mean age was 13.8 years and mean UA was 5.5 mg/dL; 24 % had elevated UA, 51 % were overweight/obese and 39 % had LVH. Measures of adiposity, low high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, LVM and LVH were all significantly associated with elevated UA at baseline, but not with change over time. Each 1 mg/dL increase in baseline UA was associated with a 2.5 g/m2.7 increase in the LVM index at follow-up (95 % confidence interval 0.64, 4.39; p = 0.01); after adjustment for age, sex, race, body mass index z-score, change in UA, time, blood pressure and medication use, this association was no longer significant. Conclusions: Hypertensive children with elevated UA have a higher prevalence of obesity-related CVD risk factors. Among hypertensive children, UA may be a marker of adiposity and not an independent CVD risk factor.

Original languageEnglish (US)
Pages (from-to)2169-2176
Number of pages8
JournalPediatric Nephrology
Volume30
Issue number12
DOIs
StatePublished - Jul 2 2015

Fingerprint

Uric Acid
Cardiovascular Diseases
Obesity
Left Ventricular Hypertrophy
Adiposity
C-Reactive Protein
LDL Cholesterol
HDL Cholesterol
Observational Studies
Body Mass Index
Prospective Studies
Confidence Intervals
Blood Pressure
Hypertension

Keywords

  • Blood pressure
  • Cardiovascular disease
  • Children
  • Left ventricular hypertrophy
  • Longitudinal
  • Obesity
  • Uric acid

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

Reschke, L. D., Miller, E. R., Fadrowski, J. J., Loeffler, L. F., Holmes, K., Appel, L. J., & Brady, T. M. (2015). Elevated uric acid and obesity-related cardiovascular disease risk factors among hypertensive youth. Pediatric Nephrology, 30(12), 2169-2176. https://doi.org/10.1007/s00467-015-3154-y

Elevated uric acid and obesity-related cardiovascular disease risk factors among hypertensive youth. / Reschke, Lauren D.; Miller, Edgar R.; Fadrowski, Jeffrey J.; Loeffler, Lauren F.; Holmes, Kathryn; Appel, Lawrence J.; Brady, Tammy M.

In: Pediatric Nephrology, Vol. 30, No. 12, 02.07.2015, p. 2169-2176.

Research output: Contribution to journalArticle

Reschke, LD, Miller, ER, Fadrowski, JJ, Loeffler, LF, Holmes, K, Appel, LJ & Brady, TM 2015, 'Elevated uric acid and obesity-related cardiovascular disease risk factors among hypertensive youth', Pediatric Nephrology, vol. 30, no. 12, pp. 2169-2176. https://doi.org/10.1007/s00467-015-3154-y
Reschke, Lauren D. ; Miller, Edgar R. ; Fadrowski, Jeffrey J. ; Loeffler, Lauren F. ; Holmes, Kathryn ; Appel, Lawrence J. ; Brady, Tammy M. / Elevated uric acid and obesity-related cardiovascular disease risk factors among hypertensive youth. In: Pediatric Nephrology. 2015 ; Vol. 30, No. 12. pp. 2169-2176.
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abstract = "Background: Uric acid (UA) is associated with high blood pressure in adolescents and with left ventricular hypertrophy (LVH) and cardiovascular disease (CVD) in adults. We sought to determine if UA is independently associated with CVD risk factors and left ventricular mass (LVM) over time in hypertensive youth. Methods: This was a 1-year prospective observational study of hypertensive children aged 3–19 years. Cross-sectional and longitudinal associations of serum UA with CVD risk factors and LVM were explored. Results: Of the 49 children who completed both the baseline and 12-month assessments, at baseline the mean age was 13.8 years and mean UA was 5.5 mg/dL; 24 {\%} had elevated UA, 51 {\%} were overweight/obese and 39 {\%} had LVH. Measures of adiposity, low high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, LVM and LVH were all significantly associated with elevated UA at baseline, but not with change over time. Each 1 mg/dL increase in baseline UA was associated with a 2.5 g/m2.7 increase in the LVM index at follow-up (95 {\%} confidence interval 0.64, 4.39; p = 0.01); after adjustment for age, sex, race, body mass index z-score, change in UA, time, blood pressure and medication use, this association was no longer significant. Conclusions: Hypertensive children with elevated UA have a higher prevalence of obesity-related CVD risk factors. Among hypertensive children, UA may be a marker of adiposity and not an independent CVD risk factor.",
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AU - Loeffler, Lauren F.

AU - Holmes, Kathryn

AU - Appel, Lawrence J.

AU - Brady, Tammy M.

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N2 - Background: Uric acid (UA) is associated with high blood pressure in adolescents and with left ventricular hypertrophy (LVH) and cardiovascular disease (CVD) in adults. We sought to determine if UA is independently associated with CVD risk factors and left ventricular mass (LVM) over time in hypertensive youth. Methods: This was a 1-year prospective observational study of hypertensive children aged 3–19 years. Cross-sectional and longitudinal associations of serum UA with CVD risk factors and LVM were explored. Results: Of the 49 children who completed both the baseline and 12-month assessments, at baseline the mean age was 13.8 years and mean UA was 5.5 mg/dL; 24 % had elevated UA, 51 % were overweight/obese and 39 % had LVH. Measures of adiposity, low high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, LVM and LVH were all significantly associated with elevated UA at baseline, but not with change over time. Each 1 mg/dL increase in baseline UA was associated with a 2.5 g/m2.7 increase in the LVM index at follow-up (95 % confidence interval 0.64, 4.39; p = 0.01); after adjustment for age, sex, race, body mass index z-score, change in UA, time, blood pressure and medication use, this association was no longer significant. Conclusions: Hypertensive children with elevated UA have a higher prevalence of obesity-related CVD risk factors. Among hypertensive children, UA may be a marker of adiposity and not an independent CVD risk factor.

AB - Background: Uric acid (UA) is associated with high blood pressure in adolescents and with left ventricular hypertrophy (LVH) and cardiovascular disease (CVD) in adults. We sought to determine if UA is independently associated with CVD risk factors and left ventricular mass (LVM) over time in hypertensive youth. Methods: This was a 1-year prospective observational study of hypertensive children aged 3–19 years. Cross-sectional and longitudinal associations of serum UA with CVD risk factors and LVM were explored. Results: Of the 49 children who completed both the baseline and 12-month assessments, at baseline the mean age was 13.8 years and mean UA was 5.5 mg/dL; 24 % had elevated UA, 51 % were overweight/obese and 39 % had LVH. Measures of adiposity, low high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, LVM and LVH were all significantly associated with elevated UA at baseline, but not with change over time. Each 1 mg/dL increase in baseline UA was associated with a 2.5 g/m2.7 increase in the LVM index at follow-up (95 % confidence interval 0.64, 4.39; p = 0.01); after adjustment for age, sex, race, body mass index z-score, change in UA, time, blood pressure and medication use, this association was no longer significant. Conclusions: Hypertensive children with elevated UA have a higher prevalence of obesity-related CVD risk factors. Among hypertensive children, UA may be a marker of adiposity and not an independent CVD risk factor.

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KW - Cardiovascular disease

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KW - Longitudinal

KW - Obesity

KW - Uric acid

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