gms | German Medical Science

Question: Hyperuricemia has been known to increase the risk of morbidity and mortality from cardiovascular diseases. Recent study showed a relation between hyperuricemia and left ventricular hypertrophy (LVH) in hypertensive patients. Present study was conducted to assess whether hyperuricemia is associated with LVH independently of hypertension (HTN).

Method Used: A workers’ population of 2816 men were subjected to analysis. They were divided into quartile by serum uric acid (UA) level. We evaluated the relationship between UA level and LVH defined as meeting either one or both of electrocardiographic (ECG) criteria: Sokolow-Lyon voltage and Cornell product, i.e., RaVL+SV3 multiplied by QRS duration. Odds ratio (OR) of LVH for hyperuricemia was calculated through logistic regression model by adjusting for known confounders, i.e., age, medication of HTN, body mass index (BMI) , mean blood pressure (MBP) and serum level of creatinine (Cre). We performed the same analysis by using following 4 kinds of criteria for LVH independently, i.e., Minnesota Code, Sokolow-Lyon voltage, Cornell voltage and Cornell product, to confirm the result.

Results: The odds of LVH in the highest quartile was significantly greater than that in the lowest quartile, used as the reference group, after age, medication of HTN, BMI, MBP and Cre were adjusted simultaneously (OR 1.37, 95%CI 1.03-1.81, p = 0.029) or step by step in various combinations. However, when BMI was excluded from adjustment factors, the OR was insignificant probably because of insufficient adjustment of the effect of physique on ECG findings. The ORs were not necessarily significant when other criteria of LVH were used although the ORs were greater than unity in any criteria.

Conclusion: When causative effect of blood pressure on LVH and confounding effect of body size and renal function were adjusted statistically, higher UA level was shown to be independently related to LVH in human heart.