Uric acid levels predict CV events in postmenopausal women

High levels of uric acid independently predicted death and major adverse CV events in postmenopausal women, according to recent study findings.

The effect was most pronounced for cerebrovascular events, researchers found.

Because previous research has demonstrated that uric acid is a risk factor for CVD and that postmenopausal women often have high levels of uric acid, Angela Sciacqua, MD, and colleagues investigated whether uric acid levels in postmenopausal women predict CV morbidity and mortality. The researchers analyzed 645 postmenopausal women in the outpatient setting (mean age, 54 years) who were not taking hormone replacement therapy or drugs that could interfere with uric acid levels.

The primary endpoint was major adverse CV events, defined as CV death, MI, stroke or coronary revascularization. Mean follow-up was 72.5 months.

The women were stratified into tertiles based on uric acid level. Those with higher uric acid levels were more likely to be older and current smokers (P < .0001 for both) compared with those with lower levels.

Ninety (2.31%) new CV events occurred during follow-up. Of those, 62 were coronary events and 28 were cerebrovascular events.

Compared with the lowest and middle tertiles, women in the highest tertile of uric acid level had a higher rate of nonfatal CV events (lowest, 1.52%; middle, 2.03%; highest, 3.15%; P = .009) and major adverse CV events (lowest, 1.59%; middle, 2.11%; highest, 3.23%; P = .011), according to the results.

The researchers found differences between the groups in cerebrovascular events (lowest, 0.3%; middle, 0.62%; highest, 1.15%; P = .027), but not in coronary events (P = .214).

Sciacqua and colleagues determined that uric acid was independently associated with incident major adverse CV events (HR = 1.248; P = .001), cerebrovascular events (HR = 1.657; P < .0001) and total events, defined as major adverse CV events plus all-cause mortality (HR = 1.391; P < .0001).

“Notably and clinically relevant, this association turned out to be significantly independent of all traditional CV risk factors and menopause duration, allowing us to consider (uric acid) as an important and independent pathogenic factor for CV aging and, consequently, for clinical events,” Sciacqua, from the department of medical and surgical sciences at University Magna Graecia, Catanzaro, Italy, and colleagues wrote.

A possible explanation is that “[uric acid]-related renin-angiotensin system activation is able to impair cerebral circulation,” the researchers wrote. – by Erik Swain

Source: www.healio.com