Chandrasekaran, K (2010) Correlation between Serum Uric Acid and Essential Hypertension. Masters thesis, Madras Medical College, Chennai.
|
Text
200100110chandrasekaran.pdf Download (1MB) | Preview |
Abstract
INTRODUCTION: Cardiovascular disease is an epidemic of modern society. Hypertension is the most common form of cardiovascular disease present in nearly 25% of adults and increases in prevalence with age. Cannon et al (1966) reported that hyperuricemia was observed in 25% of untreated hypertensive subjects, 50% of those on treatment, and 75% to 100% of those with malignant hypertension or renal dysfunction. Frederick Akbar Mahomed observed that many hypertensive subjects came from gouty families, leading him to suggest uric acid as a causal factor in the blood pressure response. Haig, who proposed low purine diets as a means to prevent hypertension and vascular disease. The French academician, Henri Huchard, noted that renal arteriolosclerosis (the histological lesion of hypertension) was primarily observed in 3 groups: those with gout or lead poisoning or those with a diet enriched in fatty meat, all conditions associated with hyperuricemias. Mazzali et al (2001) has demonstrated that hyperuricemic rats develop hypertension which is associated with preglomerular vascular disease. Prevention of the renal microvascular lesions during childhood might reduce the incidence of hypertension. Bogalusa Heart Study found that uric acid levels in childhood predict the development of diastolic hypertension 10 years later. The second study, from the Framingham group, also found uric acid to predict the development of hypertension. Not only does uric acid predict the development of hypertension, but a recent study suggests that elevated uric acid is much more common in the new onset hypertensive patient than originally believed. In a study of new onset hypertension in adolescents, 89% of children with essential hypertension had a uric acid level >5.5 mg/dL versus 30% of secondary hypertension and 0% of white-coat hypertensive or control subjects. The relationship of uric acid to hypertension was independent of renal function or obesity and was strong and linear (r=0.8). Finally, pilot studies suggest that lowering uric acid in the new onset hypertensive subject can normalize blood pressure, although one must be cautious because no placebo group was included. The baseline serum uric acid level is a durable marker of risk for the development of hypertension. The association is independent of elements of the metabolic syndrome, alcohol intake, and renal function. AIMS AND OBJECTIVES: 1. To study the level of uric acid in patients with essential hypertension 2. To identify whether any association exists between ages, sex, body mass index, smoking, diabetes and target organ damage and the presence of elevated serum uric acid. MATERIALS AND METHODS: Setting: Government Rajaji Hospital and Madurai Medical College, Madurai. Collaborative Department: Department of Biochemistry, Madurai Medical College, Madurai. Study design: Cross sectional study. Period of Study: March 2009 to August 2009 Sample Size: 225 cases. Inclusion Criteria: • Patients with Essential hypertension • Patients whose ages were above 25 years were included • Both sexes were included. Exclusion Criteria: • Individuals below 25 years were excluded • Patients with renal failure • Pregnancy • Patients with secondary hypertension. • Patients who were on long-term diuretics. • Patients who were regular consumer of alcohol. • Patients who were on anti metabolite and chemotherapy Materials: Thus a total of 150 cases that satisfied the inclusion and exclusion criteria above were taken up for subsequent study. 75 age and sex matched subjects were kept as control. Methods: Selected Socio-demographic, clinical and laboratory data were elicited from the patients and controls and recorded in a proforma CONCLUSION: 1. Hyperuricemia (>7mg/dl in males and >6mg/dl in females) is found in 14% of hypertensives while none of the normotensives had hyperuricemia. 2. Serum uric acid level is significantly elevated in Essential hypertension. 3. There is no correlation between serum uric acid with age, gender, body mass index, smoking, and Diabetes. 4. Serum uric acid level is significantly elevated in cases with coronary artery disease /peripheral arterial disease as compared to those with other target organ damage. 5. In this study, 82% of hypertensive population having Serum uric acid level >4mg/dl which is now considered as a red flag in those with risk factor for cardiovascular disease.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Correlation ; Serum Uric Acid ; Essential Hypertension. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 29 Mar 2018 01:54 |
| Last Modified: | 29 Mar 2018 01:54 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6719 |
Actions (login required)
 |
View Item |
