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Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study.
Arch Intern Med 2004; 164(14):1546-51AI

Abstract

BACKGROUND

Despite abundant epidemiologic evidence, the role of elevated serum uric acid level as a cardiovascular risk factor is controversial. We assessed the predictive value of serum uric acid levels for cardiovascular and overall mortality.

METHODS

A population-based prospective cohort study was performed of 1423 middle-aged Finnish men initially without cardiovascular disease, cancer, or diabetes. The main outcome measure was death from cardiovascular disease and any cause.

RESULTS

The mean follow-up was 11.9 years. There were 157 deaths during follow-up, of which 55 were cardiovascular. In age-adjusted analyses, serum uric acid levels in the upper third were associated with a greater than 2.5-fold higher risk of death from cardiovascular disease than levels in the lower third. Taking into account cardiovascular risk factors and variables commonly associated with gout increased the relative risk to 3.73. Further adjustment for factors related to the metabolic syndrome strengthened the risk to 4.77. Excluding the 53 men using diuretics did not alter the results. In age-adjusted analyses, men with serum uric acid levels in the upper third were 1.7-fold more likely to die of any cause than men with levels in the lower third. Adjustment for further risk factors strengthened the association somewhat.

CONCLUSIONS

Serum uric acid levels are a strong predictor of cardiovascular disease mortality in healthy middle-aged men, independent of variables commonly associated with gout or the metabolic syndrome. Serum uric acid measurement is an easily available and inexpensive risk marker, but whether its relationship to cardiovascular events is circumstantial or causal remains to be answered.

Authors+Show Affiliations

Department of Medicine, Kuopio University Hospital, Kuopio, Finland. leo.niskanen@kuh.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15277287

Citation

Niskanen, Leo K., et al. "Uric Acid Level as a Risk Factor for Cardiovascular and All-cause Mortality in Middle-aged Men: a Prospective Cohort Study." Archives of Internal Medicine, vol. 164, no. 14, 2004, pp. 1546-51.
Niskanen LK, Laaksonen DE, Nyyssönen K, et al. Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study. Arch Intern Med. 2004;164(14):1546-51.
Niskanen, L. K., Laaksonen, D. E., Nyyssönen, K., Alfthan, G., Lakka, H. M., Lakka, T. A., & Salonen, J. T. (2004). Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study. Archives of Internal Medicine, 164(14), pp. 1546-51.
Niskanen LK, et al. Uric Acid Level as a Risk Factor for Cardiovascular and All-cause Mortality in Middle-aged Men: a Prospective Cohort Study. Arch Intern Med. 2004 Jul 26;164(14):1546-51. PubMed PMID: 15277287.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study. AU - Niskanen,Leo K, AU - Laaksonen,David E, AU - Nyyssönen,Kristiina, AU - Alfthan,Georg, AU - Lakka,Hanna-Maaria, AU - Lakka,Timo A, AU - Salonen,Jukka T, PY - 2004/7/28/pubmed PY - 2004/8/21/medline PY - 2004/7/28/entrez SP - 1546 EP - 51 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 164 IS - 14 N2 - BACKGROUND: Despite abundant epidemiologic evidence, the role of elevated serum uric acid level as a cardiovascular risk factor is controversial. We assessed the predictive value of serum uric acid levels for cardiovascular and overall mortality. METHODS: A population-based prospective cohort study was performed of 1423 middle-aged Finnish men initially without cardiovascular disease, cancer, or diabetes. The main outcome measure was death from cardiovascular disease and any cause. RESULTS: The mean follow-up was 11.9 years. There were 157 deaths during follow-up, of which 55 were cardiovascular. In age-adjusted analyses, serum uric acid levels in the upper third were associated with a greater than 2.5-fold higher risk of death from cardiovascular disease than levels in the lower third. Taking into account cardiovascular risk factors and variables commonly associated with gout increased the relative risk to 3.73. Further adjustment for factors related to the metabolic syndrome strengthened the risk to 4.77. Excluding the 53 men using diuretics did not alter the results. In age-adjusted analyses, men with serum uric acid levels in the upper third were 1.7-fold more likely to die of any cause than men with levels in the lower third. Adjustment for further risk factors strengthened the association somewhat. CONCLUSIONS: Serum uric acid levels are a strong predictor of cardiovascular disease mortality in healthy middle-aged men, independent of variables commonly associated with gout or the metabolic syndrome. Serum uric acid measurement is an easily available and inexpensive risk marker, but whether its relationship to cardiovascular events is circumstantial or causal remains to be answered. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/15277287/Uric_acid_level_as_a_risk_factor_for_cardiovascular_and_all_cause_mortality_in_middle_aged_men:_a_prospective_cohort_study_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.164.14.1546 DB - PRIME DP - Unbound Medicine ER -