Kumar, R (2015) A Prospective Study of Correlation between Serum Uric Acid and Dyslipidemia in Essential Hypertension. Masters thesis, Tirunelveli Medical College, Tirunelveli.
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Abstract
BACK GROUND: The association of serum uric acid with various cardiovascular risk factors have led to the debate that whether serum uric acid can be an independent risk factor in essential hypertension. Hence we carry out a study to examine the possibility of hyperuricemia in hypertension, to see if there is a relationship between the serum uric acid levels and hypertension. Hypertriglyceridemia, hypercholesterolemia, raised LDL, raised VLDL and a decreased HDL is seen in Essential hypertensives. So we examine the possibility of occurrence of dyslipedemia with respect to essential hypertension, in comparison with normotensive. Uric acid levels tend to rise with individual rise in any one of lipid parameter in hypertensive cases, in comparison to normotensives.so we evaluate the correlation of serum uric acid and dyslipedemia in essential hypertensive in comparison to normotensive. As the age increases in hypertensives, dyslipidaemia and hyperuricemia increase together, indicating uric acid as a risk factor for hypertension and its complication .The complications of hypertension like CCF, heart failure occur more due to endothelial dysfunction due to dyslipedemia and raised serum uric acid. Thus, the predilection of correlation between serum uric acid and dyslipedemia in essential hypertension will help in better management of essential hypertension and thereby preventing associated morbidities and mortalities. AIMS OF THE STUDY: 1. To measure the fasting serum uric acid levels in essential hypertensive individuals aged between 35 to 65 years and in healthy individuals aged between 35 to 65 years. 2. To measure the fasting serum levels of lipid parameters triglycerides, total cholesterol, LDL, VLDL and HDL in essential hypertensive individuals and healthy individuals aged between 35 to 65 years. 3. To analyse the possibility of correlation existing between fasting serum uric acid levels and fasting serum lipid parameters. METHODS: A Case control study consisting of 30 controls, who are healthy individuals in the age group of 35 to 65 years, with blood pressure of <140/90 mmhg and 30 hypertensive cases who are individuals in the age group of 35 to 65 years with blood pressure of >140/90mmhg is undertaken to study the relationship between serum uric acid and lipid parameters in essential hypertension in comparison to normotensive. The current study is done In Tiruneveli Medical College, Department of Medicine from our inpatient and outpatient departments from August 2013 to August 2014. Diabetes mellitus, ischemic heart disease, renal disease, jaundice, chronic liver disease, familial hyperlipidemia, patients on lipid lowering drugs, smoking, alcoholics, obese individuals and gout patients are excluded from the study population by history and physical examination. All the study population are undergone physical examination and their fasting serum uric acid and serum lipid profile taken for analysis. The information collected regarding all the selected cases were recorded in a Master Chart. The range, frequencies, percentages, means, standard deviations, chi square, ‘t’ value and 'p' values were calculated. Student’s ‘t’ test was used to test the significance of difference between quantitative variables .Yate’s and Fisher’s chi square tests for qualitative variables. A 'p' value less than 0.05 is taken to denote significant relationship. RESULTS: Blood pressure elevation is observed as the age group increases. As age increases, a rise in blood pressure elevation is observed. The level of blood pressure rise is observed more in 55-65 year age group. Also more number of hypertensives are observed in 55-65 age group. An elevated level of triglycerides, LDL, VLDL and decreased level of HDL is observed more in hypertensive group (P <0.001significant). About 24 out of 30 cases in the hypertensive group has observed to have dyslipidemia ,either as total increase in all lipid parameters or increase in any one of the lipid parameter ,excluding HDL. In control population only few of the individuals have dyslipidemia, most of the control population do not have any lipid abnormality. Only 4 of 30 have increased triglycerides and 2 of them have increased cholesterol levels. So, about 80% of hypertensive population have dyslipidemia. In control population, only 20% have dyslipidemia and they too have only increased triglyceride levels. Also the rise in lipid parameters is more with age group, more seen in 55-65 years age group and the elevation also increases with increase in blood pressure. Uric acid elevation is seen in most of the individuals in hypertensive group (P <0.0001- significant). About 25 of 30 people have elevation of serum uric acid and its elevation is directly proportional to rise in blood pressure. Uric acid level is not elevated in control group. The dyslipidemia is associated with elevation of serum uric acid in hypertensive group, where as in control group dyslipedemia is not associated with elevation of serum uric acid. CONCLUSION: Dyslipidemia is seen in essential hypertensives. Elevation of triglycerides, rise in total cholesterol, raised LDL and raised VLDL and a decrease in HDL is observed in essential hypertensives. Elevation of serum uric acid level is seen in essential hypertensives. Both dyslipidaemia and hyperuricemia observed to be elevated with increase in age in essential hypertensives. In normotensives, few have elevated triglyceride levels and elevated total cholesterol levels. Though hypertriglyceridemia increases as age increases, it is not associated with hyperuricemia. This concludes that dyslipidemia is correlated to hyperuricemia in essential hypertensives and not in normotensives.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | serum uric acid ; dyslipedemia ; essential hypertension ; correlation. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Punitha K |
| Date Deposited: | 18 May 2018 18:56 |
| Last Modified: | 18 May 2018 18:56 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7949 |
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