Uric Acid Excretion Predicts Increased Blood Pressure Among American Adolescents of African Descent

• Published in: The American journal of the medical sciences 2017-04, Vol.353 (4), p.336-341
• Main Authors: Mrug, Sylvie, PhD, Mrug, Michal, MD, Morris, Anjana Madan, PhD, Reynolds, Nina, PhD, Patel, Anita, MD, Hill, Danielle C., BA, Feig, Daniel I., MD
• Format: Article
• Language: English
• Subjects: Adolescent; African American; Black or African American; Black People; Blood Pressure; Female; Humans; Internal Medicine; Male; Pediatric; Uric acid; Uric Acid - urine
• ISSN: 0002-9629; 1538-2990; 1538-2990
• DOI: 10.1016/j.amjms.2017.01.008

Abstract Background Hyperuricemia predicts the incidence of hypertension in adults and its treatment has blood pressure (BP) lowering effects in adolescents. To date, no studies have examined the predictive utility of hyperuricemia or urinary uric acid excretion on BP changes in adolescents. Mechanistic models suggest uric acid impairs both endothelial function and vascular compliance which would potentially exacerbate a myriad of hypertensive mechanisms, yet little is known about interaction of uric acid and other hypertension risk factors. Methods The primary study was aimed at the effects of stress on BP in adolescents. A community sample of 84 low-income, urban adolescents (50% male, 95% African American, mean age 13.36 ± 1 years) was recruited from public schools. Youth completed a 12-hour (overnight) urine collection at home and their BP was measured during rest and in response to acute psychosocial stress. 76 of the adolescents participated in a follow up visit at 1.5 years when their resting BP was reassessed. In this sub-study, we assessed the relationship of renal urate excretion and BP reactivity. Results After adjusting for resting BP levels at baseline and other covariates, higher levels of uric acid excretion predicted greater BP reactivity to acute psychosocial stress and higher resting BP at 18 months. Conclusions Urinary excretion of uric acid can serve as an alternative, noninvasive measure of serum uric acid levels that are predictive of BP changes. Since hyperuricemia-associated hypertension is treatable, urban adolescents may benefit from routine screening for hyperuricemia or high uric acid excretion.