无症状高尿酸血症对老年高血压患者全因死亡及心血管事件的影响

Effect of asymptomatic hyperuricemia on all-cause death and cardiovascular events in elderly hypertensive patients

目的探讨无症状高尿酸血症对老年高血压患者全因死亡及心血管事件的影响。方法选择2010年10月~2014年6月解放军总医院第二医学中心就诊的老年高血压患者743例,根据诊断分为无症状高尿酸血症组122例和非高尿酸血症组621例。采用Cox比例风险回归模型分析无症状高尿酸血症与全因死亡及心血管事件的关系。结果无症状高尿酸血症组年龄、冠心病和血尿酸水平明显高于非高尿酸血症组,舒张压水平明显低于非高尿酸血症组,差异有统计学意义(P<0.05,P<0.01)。无症状高尿酸血症组全因死亡的累积发生率明显高于非高尿酸血症组(41.6%vs 33.7%,P=0.000)。多因素Cox比例风险回归模型分析中,无症状高尿酸血症组全因死亡、非致死性心肌梗死分别是非高尿酸血症组的1.570倍(95%CI:1.062~2.322,P=0.024)、2.278倍(95%CI:2.278~4.902,P=0.035)。结论无症状高尿酸血症是心血管疾病的危险因素,导致老年高血压患者全因死亡及非致死性心肌梗死发生率显著增加。

Objective To study the effect of asymptomatic hyperuricemia on all-cause death and cardiovascular events in elderly hypertensive patients.Methods Seven hundred and forty-three elderly hypertensive patients admitted to our center from October 2010 to June 2014 were divided into asymptomatic hyperuricemia group(n=122)and hyperuricemia-free group(n=621).The relationship of asymptomatic hyperuricemia with all-cause death and cardiovascular events was analyzed by Cox proportional hazards analysis.Results The age was significantly older,the incidence of CHD and the serum level of UA were significantly higher while the DBP was significantly lower in asymptomatic hyperuricemia group than in hyperuricemia-free group(P<0.05,P<0.01).The cumulative incidence of all-cause death was significantly higher in asymptomatic hyperuricemia group than in hyperuricemia-free group(41.6%vs 33.7%,P=0.000).Multivariate Cox proportional hazards analysis showed that the incidence of all-cause death and non-fatal myocardial infarction was 1.570-fold higher and 2.278-fold higher respectively in asymptomatic hyperuricemia group than in hyperuricemia-free group(95%CI:1.062-2.322,P=0.024;95%CI:2.278-4.902,P=0.035).Conclusion Asymptomatic hyperuricemia is a risk factor for cardiovascular events and can significantly increase the incidence of all-cause death and cardiovascular events in elderly hypertensive patients.