Asimptomatska hiperuricemija u liječenih hipertoničara

master's thesis

• Title (english): Asymptomatic hyperuricemia in treated hypertensive patients
• Author: Narcisse Nasri
• Mentor: Sandra Karanović (mentor)
• Committee member: Živka Dika (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Sandra Karanović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

UVOD: Asimptomatska hiperuricemija predstavlja stanje s povišenom razinom serumske mokraćne kiseline (MK) iznad 6mg/dl (1) ili >6.8 mg/dl prema ACR smjernicama (2), kod muškaraca i žena bez simptoma ili znakova odlaganja mononatrijeva urata, tj. bez kliničke slike gihta, uratne nefropatije ili uratne nefrolitijaze. Povezana je s arterijskom hipertenzijom, metaboličkim sindromom i kroničnom bubrežnom bolešću (3). ----- CILJ: Cilj ovog istraživanja bilo je odrediti prevalenciju asimptomatske hiperuricemije kod liječenih hipertoničara. ----- MATERIJALI I METODE: Istraživanje je provedeno u nefrološkim ambulantama za hipertenziju u tri bolnice u Hrvatskoj. Pedeset i sedam konsekutivnih liječenih hipertoničara je uključeno u istraživanje. Pacijenti su ispunili predefinirani upitnik s informacijama o tjelesnoj težini, visini, ITM, kardiovaskularnim čimbenicima rizika, trenutnoj terapiji, komorbiditetima i prethodnim napadajima gihta ili uratne nefrolitijaze odnosno podatke o ev. uratnoj nefropatiji. Serumski urati izmjereni su uređajem HumaSens/HumaSensplus. Srčana frekvencija i krvni tlak su izmjereni prema smjernicama Europskog društva za hipertenziju. ----- REZULTATI: Od 57 ispitanika njih 55 nije imao podatak o bolestima taloženje urata i uključeno je u daljnje analize. Prosječna vrijednost sistoličkog tlaka za cijelu skupinu bila je 138 mmHg (±16.9 mmHg), a dijastoličkog tlaka 80.6 (±10.6 mmHg). Medijan vrijednosti MK u krvi za cijelu skupinu je iznosio 438 umol/l (raspon:200-797). Nije bilo statističke razlike u vrijednosti urata između spolova (p= 0.0729), pušača i nepušača (p=0.145196), osoba koje su
konzumirale alkohol u odnosu na one koje nisu (p= 0.078580). Također nije pronađena značajna statistička razlika u MK između 4 različite podskupine ITM (p = 0.140928) odnosno kod osoba koje su koristile diuretika u odnosu na one bez diuretika u terapiji (p= 0. 017463). MK je značajno bila viša u osoba s preboljelim CVI/TIA u odnosu na osobe bez (p=0.473327). Nije utvrđena značajna korelacije između MK i dobi, arterijskog tlaka ili srčane frekvencije (p>0.05). Prevalencije asimptomatske hiperuricemije za našu kohortu iznosila je 89%. ----- ZAKLJUČAK: Osamdeset devet posto liječenih hipertoničara uključenih u ovom istraživanje
imalo je koncentraciju serumskih urata iznad normalne razine, tj. asimptomatsku hiperuricemiju. Ostaje upitno bi li liječenje asimptomatske hiperuricemije poboljšalo renalne i kardiovaskularne ishode ovakvim bolesnicima.

Abstract (english)

INTRODUCTION: Asymptomatic hyperuricemia is a condition with increased serum uric acid (SUA) levels > 6 mg/dl (1) or >6.8 mg/dl according to ACR guidelines (2) in both man and women without symptoms or signs of monosodium urate deposition disease, that is without clinical gout or uric acid renal disease (4). Asymptomatic hyperuricemia is associated with arterial hypertension, metabolic syndrome and chronic kidney disease (3). ----- OBJECTIVE: The aim of this study was to verify the prevalence of asymptomatic hyperuricemia in treated hypertensive patients. ----- MATERIALS AND METHODS: The study was conducted in outpatient hypertension clinics in three hospitals in Croatia. Fifty-seven consecutive treated hypertensive patients were enrolled. Patients were administered a predefined questionnaire including data on body weight, height, body mass index, cardiovascular risk factors, current therapy, comorbidities and previous attacks of gout or uric acid renal disease. Uric acid levels were measured using the HumaSens/HumaSensplus device. Heart rate and blood pressure measurements were performed according to ESH/ESC guidelines. ----- RESULTS: Out of 57 patients 55 did not have previous gout or uric acid renal disease episodes and were included into further analyses. The mean systolic and diastolic blood pressure for the whole group was 138 mmHg (±16.9 mmHg) and 80.6 (±10.6) mmHg. The median of SUA was 438 umol/l (range: 200-797). There were no significant differences of SUA values between genders (p= 0.0729), smokers vs. nonsmokers (p=0.145196), persons consuming alcohol vs non-consumers (p= 0.078580). No statistically significant differences were found in SUA levels between 4 subgroups of BMI (p = 0.140928) and between subjects who were taking diuretics vs ones who did not (p= 0. 017463). SUA values were significantly higher in subgroup of subjects who previously had TIA/CVI vs ones who did not (p=0. 473327). There was no correlation between SUA levels and age, blood pressure or heart rate (p>0.05). The of prevalence asymptomatic hyperuricemia in our cohort was 89%. ----- CONCLUSION: Eighty-nine percent of treated hypertensive patients from our cohort had SUA levels above normal, that is asymptomatic hyperuricemia. It is still an opened question whether treatment of asymptomatic hyperuricemia could enhance ardiovascular and renal outcomes.

• Keywords: asimptomatska hiperuricemija; arterijski tlak; serumska mokraćna kiselina
• Keywords (english): asymptomatic hyperuricemia; arterial hypertension; serum uric acid
• Language: croatian
• URN:NBN: urn:nbn:hr:105:787345
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-03-24 10:11:13