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Uric acid: role in cardiovascular disease and effects of losartan.
Curr Med Res Opin. 2004 Mar; 20(3):369-79.CM

Abstract

A substantial body of epidemiological and experimental evidence suggests that serum uric acid is an important, independent risk factor for cardiovascular and renal disease especially in patients with hypertension, heart failure, or diabetes. Elevated serum uric acid is highly predictive of mortality in patients with heart failure or coronary artery disease and of cardiovascular events in patients with diabetes. Further, patients with hypertension and hyperuricemia have a 3- to 5-fold increased risk of experiencing coronary artery disease or cerebrovascular disease compared with patients with normal uric acid levels. Although the mechanisms by which uric acid may play a pathogenetic role in cardiovascular disease is unclear, hyperuricemia is associated with deleterious effects on endothelial dysfunction, oxidative metabolism, platelet adhesiveness, hemorheology, and aggregation. Xanthine oxidase inhibitors (e.g., allopurinol) or a variety of uricosuric agents (e.g., probenecid, sulfinpyrazone, benzbromarone, and benziodarone) can lower elevated uric acid levels but it is unknown whether these agents reversibly impact cardiovascular outcomes. However, the findings of the recent LIFE study in patients with hypertension and left ventricular hypertrophy suggest the possibility that a treatment-induced decrease in serum uric acid may indeed attenuate cardiovascular risk. LIFE showed that approximately 29% (14% to 107%, p = 0.004) of the treatment benefit of a losartan-based versus atenolol-based therapy on the primary composite endpoint (death, myocardial infarction, or stroke) may be ascribed to differences in achieved serum uric acid levels. Overall, serum uric acid may be a powerful tool to help stratify risk for cardiovascular disease. At the very least, it should be carefully considered when evaluating overall cardiovascular risk.

Authors+Show Affiliations

Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461-1602, USA. alderman@aecom.yu.eduNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

15025846

Citation

Alderman, Michael, and Kala J V. Aiyer. "Uric Acid: Role in Cardiovascular Disease and Effects of Losartan." Current Medical Research and Opinion, vol. 20, no. 3, 2004, pp. 369-79.
Alderman M, Aiyer KJ. Uric acid: role in cardiovascular disease and effects of losartan. Curr Med Res Opin. 2004;20(3):369-79.
Alderman, M., & Aiyer, K. J. (2004). Uric acid: role in cardiovascular disease and effects of losartan. Current Medical Research and Opinion, 20(3), 369-79.
Alderman M, Aiyer KJ. Uric Acid: Role in Cardiovascular Disease and Effects of Losartan. Curr Med Res Opin. 2004;20(3):369-79. PubMed PMID: 15025846.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Uric acid: role in cardiovascular disease and effects of losartan. AU - Alderman,Michael, AU - Aiyer,Kala J V, PY - 2004/3/18/pubmed PY - 2004/6/21/medline PY - 2004/3/18/entrez SP - 369 EP - 79 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 20 IS - 3 N2 - A substantial body of epidemiological and experimental evidence suggests that serum uric acid is an important, independent risk factor for cardiovascular and renal disease especially in patients with hypertension, heart failure, or diabetes. Elevated serum uric acid is highly predictive of mortality in patients with heart failure or coronary artery disease and of cardiovascular events in patients with diabetes. Further, patients with hypertension and hyperuricemia have a 3- to 5-fold increased risk of experiencing coronary artery disease or cerebrovascular disease compared with patients with normal uric acid levels. Although the mechanisms by which uric acid may play a pathogenetic role in cardiovascular disease is unclear, hyperuricemia is associated with deleterious effects on endothelial dysfunction, oxidative metabolism, platelet adhesiveness, hemorheology, and aggregation. Xanthine oxidase inhibitors (e.g., allopurinol) or a variety of uricosuric agents (e.g., probenecid, sulfinpyrazone, benzbromarone, and benziodarone) can lower elevated uric acid levels but it is unknown whether these agents reversibly impact cardiovascular outcomes. However, the findings of the recent LIFE study in patients with hypertension and left ventricular hypertrophy suggest the possibility that a treatment-induced decrease in serum uric acid may indeed attenuate cardiovascular risk. LIFE showed that approximately 29% (14% to 107%, p = 0.004) of the treatment benefit of a losartan-based versus atenolol-based therapy on the primary composite endpoint (death, myocardial infarction, or stroke) may be ascribed to differences in achieved serum uric acid levels. Overall, serum uric acid may be a powerful tool to help stratify risk for cardiovascular disease. At the very least, it should be carefully considered when evaluating overall cardiovascular risk. SN - 0300-7995 UR - https://www.unboundmedicine.com/medline/citation/15025846/Uric_acid:_role_in_cardiovascular_disease_and_effects_of_losartan_ L2 - https://www.tandfonline.com/doi/full/10.1185/030079904125002982 DB - PRIME DP - Unbound Medicine ER -