高血压(HTN)是一个全球性的健康问题,因为它的患病率越来越高,并且与危及生命的并发症有关。HTN研究中一个有趣的研究领域是HTN与高尿酸血症之间的关系。鉴于此,我们对探讨血清尿酸(sUA)浓度升高与新发HTN之间联系的相关研究进行了综述.通过对PubMedCentral的全面搜索,MEDLINE,和PubMed数据库,我们确定了20项符合纳入标准的研究.这项研究包括各种研究设计,包括队列研究,横断面研究,reviews,和临床试验。病理上,升高的sUA水平激活肾素-血管紧张素系统,也导致尿酸盐晶体的形成,引发肾脏炎症.此外,对内皮的直接影响导致炎症,氧化应激,一氧化氮消耗,和平滑肌细胞增殖,最终导致动脉粥样硬化.这些不同的机制共同在HTN的发病机理中发挥作用。有趣的是,已显示降低sUA可以逆转依赖尿酸的早期HTN。然而,在不依赖尿酸的第二阶段HTN中未观察到这种效应.各种研究表明,sUA水平与不同人群和性别之间的HTN患病率之间存在独立且剂量依赖性的关联。该综述强调了降尿酸药物的潜在作用,像别嘌呤醇,在HTN的预防和早期管理中。然而,关于其他降尿酸药物和联合疗法的疗效的研究很少.我们相信我们的评论提供了令人信服的证据,证明sUA浓度升高与新发HTN之间存在关联。识别和管理高尿酸血症可以提供一种预防方法,以减轻HTN及其相关并发症的负担。
Hypertension (HTN) is a global health concern due to its increasing prevalence and association with life-threatening complications. An intriguing area of investigation in HTN research is the relationship between HTN and hyperuricemia. In light of this, we conducted a review to summarize the relevant studies exploring the link between elevated serum uric acid (sUA) concentration and new-onset HTN. Through a comprehensive search of PubMed Central, MEDLINE, and PubMed databases, we identified 20 studies that met our inclusion criteria. The research encompassed various study designs, including cohort studies, cross-sectional studies, reviews, and clinical trials. Pathologically, the elevated sUA levels activate the renin-angiotensin system and also cause the formation of urate crystals, triggering inflammation in the kidneys. Additionally, direct effects on the endothelium contribute to inflammation, oxidative stress, nitric oxide depletion, and smooth muscle cell proliferation, ultimately leading to atherosclerosis. These diverse mechanisms collectively play a role in the pathogenesis of HTN. Interestingly, lowering sUA has been shown to reverse early-stage HTN dependent on uric acid. However, this effect is not observed in the uric acid-independent second stage of HTN. Various studies have demonstrated an independent and dose-dependent association between sUA levels and the prevalence of HTN across different populations and genders. The review highlights the potential role of uric acid-lowering drugs, like allopurinol, in the prevention and early-stage management of HTN. However, there is scarce research on the efficacy of other uric acid-lowering agents and combination therapies. We believe our review provides compelling evidence of the association between elevated sUA concentration and new-onset HTN. Identifying and managing hyperuricemia can provide a preventive approach to reducing the burden of HTN and its associated complications.