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Serum uric acid and the risk of mortality during 23 years follow-up in the Scottish Heart Health Extended Cohort Study.
Atherosclerosis 2014; 233(2):623-9A

Abstract

BACKGROUND

Elevated uric acid is a prevalent condition with controversial health consequences. Observational studies disagree with regard to the relationship of uric acid with mortality, and with factors modifying this relationship.

OBJECTIVE

We examined the association of serum uric acid with mortality in 15,083 participants in the Scottish Heart Health Extended Cohort (SHHEC) Study.

METHODS

Serum uric acid was measured at study enrollment. Death was ascertained using both the Scottish death register and record linkage.

RESULTS

During a median follow-up of 23 years, there were 3980 deaths. In Cox proportional hazards models with sexes combined, those in the highest fifth of uric acid had significantly greater mortality (HR 1.18, 95% CI: 1.06, 1.31) compared with the second fifth, after adjustment for traditional cardiovascular risk factors. This relationship was modified by sex (P-interaction=0.002) with adjusted HRs of 1.69 (95% CI: 1.40, 2.04) and 0.99 (95% CI: 0.86, 1.14) in women and men, respectively. Compared with the second fifth, the highest fifth of uric acid was most associated with kidney-related death (HR: 2.08, 95% CI: 1.31, 3.32).

CONCLUSION

Elevated uric acid is associated with earlier mortality, especially in women. Future studies should evaluate mechanisms for these interactions and explore the strong association with renal-related mortality.

Authors+Show Affiliations

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD, USA; Department of Medicine, Johns Hopkins University School of Medicine, Australia.Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, University of Dundee, Australia.Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD, USA; Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, University of Dundee, Australia; The George Institute for Global Health, Australia. Electronic address: markw@georgeinstitute.org.au.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24534458

Citation

Juraschek, Stephen P., et al. "Serum Uric Acid and the Risk of Mortality During 23 Years Follow-up in the Scottish Heart Health Extended Cohort Study." Atherosclerosis, vol. 233, no. 2, 2014, pp. 623-9.
Juraschek SP, Tunstall-Pedoe H, Woodward M. Serum uric acid and the risk of mortality during 23 years follow-up in the Scottish Heart Health Extended Cohort Study. Atherosclerosis. 2014;233(2):623-9.
Juraschek, S. P., Tunstall-Pedoe, H., & Woodward, M. (2014). Serum uric acid and the risk of mortality during 23 years follow-up in the Scottish Heart Health Extended Cohort Study. Atherosclerosis, 233(2), pp. 623-9. doi:10.1016/j.atherosclerosis.2014.01.026.
Juraschek SP, Tunstall-Pedoe H, Woodward M. Serum Uric Acid and the Risk of Mortality During 23 Years Follow-up in the Scottish Heart Health Extended Cohort Study. Atherosclerosis. 2014;233(2):623-9. PubMed PMID: 24534458.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum uric acid and the risk of mortality during 23 years follow-up in the Scottish Heart Health Extended Cohort Study. AU - Juraschek,Stephen P, AU - Tunstall-Pedoe,Hugh, AU - Woodward,Mark, Y1 - 2014/01/30/ PY - 2013/09/23/received PY - 2013/12/25/revised PY - 2014/01/10/accepted PY - 2014/2/19/entrez PY - 2014/2/19/pubmed PY - 2014/12/17/medline KW - Cancer KW - Cardiovascular disease KW - Cohort KW - Hyperuricemia KW - Kidney disease KW - Mortality KW - Scottish Heart Health Extended Cohort (SHHEC) KW - Uric acid SP - 623 EP - 9 JF - Atherosclerosis JO - Atherosclerosis VL - 233 IS - 2 N2 - BACKGROUND: Elevated uric acid is a prevalent condition with controversial health consequences. Observational studies disagree with regard to the relationship of uric acid with mortality, and with factors modifying this relationship. OBJECTIVE: We examined the association of serum uric acid with mortality in 15,083 participants in the Scottish Heart Health Extended Cohort (SHHEC) Study. METHODS: Serum uric acid was measured at study enrollment. Death was ascertained using both the Scottish death register and record linkage. RESULTS: During a median follow-up of 23 years, there were 3980 deaths. In Cox proportional hazards models with sexes combined, those in the highest fifth of uric acid had significantly greater mortality (HR 1.18, 95% CI: 1.06, 1.31) compared with the second fifth, after adjustment for traditional cardiovascular risk factors. This relationship was modified by sex (P-interaction=0.002) with adjusted HRs of 1.69 (95% CI: 1.40, 2.04) and 0.99 (95% CI: 0.86, 1.14) in women and men, respectively. Compared with the second fifth, the highest fifth of uric acid was most associated with kidney-related death (HR: 2.08, 95% CI: 1.31, 3.32). CONCLUSION: Elevated uric acid is associated with earlier mortality, especially in women. Future studies should evaluate mechanisms for these interactions and explore the strong association with renal-related mortality. SN - 1879-1484 UR - https://www.unboundmedicine.com/medline/citation/24534458/Serum_uric_acid_and_the_risk_of_mortality_during_23_years_follow_up_in_the_Scottish_Heart_Health_Extended_Cohort_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-9150(14)00051-3 DB - PRIME DP - Unbound Medicine ER -