Abstract

Hyperuricemia in prehypertension & hypertension may be causal or a consequence. Hyperuricemia is found to stimulate smooth muscles in vessel wall and induce endothelial dysfunction which plays a critical role in pathogenesis of hypertension. Hypertension can, in turn, induce renal dysfunction resulting in reduction in GFR and renal urate excretion. Though studies show elevated uric acid levels in both the Prehypertensive and hypertensive groups, studies analysing the correlation of uric acid levels among the Prehypertensive and hypertensive groups are few. Aim of the study 1. To evaluate for the presence of Asymptomatic Hyperuricemia in Normotensive, Pre hypertensive and Hypertensive Population 2. To compare qualitatively and quantitatively, the serum Uric Acid levels in various Hypertensive classification groups. Methods & Materials: This was a prospective observational study done in SV Medical College Hospital in 300 patients selected randomly from outpatient clinics in the Department of Medicine, SVMC. The subjects were evaluated for presence of Hypertension and were classified as per JNC VII Recommendation (Normotensive, Pre- Hypertensive, Hypertensive- stage I & II). Other details such as presence of hypertension and diabetes mellitus were noted. Anthropometric measurements were taken for them and BMI was calculated. Serum Uric Acid, along with fasting blood glucose and serum cholesterol was estimated in these patients. All the data were collected on a proforma prepared for this study and was analysed. Hyperuricemia is taken as S. Uric Acid≥ 6.8mg/dl. Conclusion: The findings in my study reinstate the analyses done in western world on the correlation between uric acid and hypertension. All hypertensive groups have elevated uric acid levels. The strongest correlation among the hypertensive groups is found in stage II Hypertension. It is also seen that as the stage of hypertension increases, the mean uric acid levels also increase. There is a sudden rise in the mean values from stage I to stage II. This suggests that there might be a significant role of uric acid in pathophysiology of complications of hypertension as it is well established that higher grades of hypertension are associated with greater degree of end organ damage. Asymptomatic hyperuricemia (S. Uric acid≥ 6.8 mg/dl) is significantly associated with all factors making up the components of metabolic syndrome, consistent with similar studies done in this regard. The correlation between serum uric acid levels and hypertension is an important paradigm in the identification of multiple factors involved in the pathophysiology of hypertension. The need for this comes from the fact that hypertension is a major morbidity and mortality factor which is becoming increasingly prevalent in our country. As further studies are in progress, there may come a time when drugs lowering uric acid may play a role in primary prevention of hypertension or secondary prevention of complications.

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