The independent impact of congestive heart failure status and diuretic use on serum uric acid among men with a high cardiovascular risk profile: a prospective longitudinal study.

Pubmed ID: 21435695

Pubmed Central ID: PMC4228774

Journal: Seminars in arthritis and rheumatism

Publication Date: Dec. 1, 2011

MeSH Terms: Humans, Male, Adult, Risk Factors, Middle Aged, Longitudinal Studies, Heart Failure, Prospective Studies, Diuretics, Hyperuricemia, Uric Acid

Grants: P60 AR047785, T32 AR007598

Authors: Zhang Y, Choi HK, Misra D, Zhu Y

Cite As: Misra D, Zhu Y, Zhang Y, Choi HK. The independent impact of congestive heart failure status and diuretic use on serum uric acid among men with a high cardiovascular risk profile: a prospective longitudinal study. Semin Arthritis Rheum 2011 Dec;41(3):471-6. Epub 2011 Mar 24.

Studies:

Abstract

OBJECTIVE: To evaluate the independent impact of congestive heart failure (CHF) status (compensation or decompensation) on serum uric acid levels among men with high cardiovascular risk profile. METHOD: We analyzed 11,681 men from the Multiple Risk Factor Interventional Trial, using data prospectively collected at baseline and annually over 6 years (64,644 visits). We evaluated the impact of change in CHF status during study follow-up, as compared with study baseline, on hyperuricemia (serum uric acid ≥7 mg/dL) and serum uric acid levels, using generalized estimating equations, adjusting for age, race, weight, weight change, education, alcohol intake, diuretic use, hypertension, serum creatinine level, and dietary factors. Similarly, we evaluated the independent impact of change in diuretic use (initiation or discontinuation). RESULTS: At baseline, mean serum uric acid was 6.88 mg/dL. Compared with no change in CHF status, odds ratios of hyperuricemia were 1.67 (95% CI, 1.21 to 2.32) for CHF decompensation and 0.21 (95% CI, 0.08 to 0.55) for compensation. The corresponding uric acid differences were 0.41 (95% CI, 0.20 to 0.62) and -1.00 (95% CI, -1.72 to -0.27), respectively. The odds ratios for initiation and discontinuation of diuretic were 3.32 (95% CI, 3.06 to 3.61) and 0.39 (95% CI, 0.35 to 0.44). CONCLUSIONS: CHF decompensation and diuretic use are both independently associated with increased odds of hyperuricemia among men with a high cardiovascular risk profile, whereas CHF recovery and diuretic discontinuation are associated with substantially lower odds of hyperuricemia.