Hyperuricemia in Childhood Primary Hypertension

• Published in: Hypertension (Dallas, Tex. 1979) Vol. 42; no. 3; pp. 247 - 252
• Main Authors: Feig, Daniel I., Johnson, Richard J.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Lippincott 01.09.2003; Hagerstown, MD American Heart Association, Inc
• Subjects: Adolescent; Analysis of Variance; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure - physiology; Body Mass Index; Cardiology. Vascular system; Child; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Diastole; Female; Glomerular Filtration Rate; Humans; Hypertension - blood; Hypertension - physiopathology; Hyperuricemia - blood; Male; Medical sciences; Obesity - physiopathology; Systole; Uric Acid - blood; Human; Hypertension; Pathogenesis; Clinical form; Cardiovascular disease; Metabolic diseases; renal disease; Hyperuricemia; hypertension, essential; children; Primary; Arterial pressure; Purine; Child; uric acid
• ISSN: 0194-911X; 1524-4563; 1524-4563
• DOI: 10.1161/01.HYP.0000085858.66548.59

Experimental animal models suggest that uric acid might have a pathogenic role in the early development of primary hypertension. We hypothesized that serum uric acid is correlated with blood pressure in children with new-onset, untreated, primary hypertension. We evaluated 125 consecutive children referred to the Baylor Pediatric Renal Program for evaluation of hypertension. None of the subjects had previously been evaluated or treated for hypertension. The children ranged in age from 6 to 18 years (mean, 13.4±3.3) and had normal renal function (creatinine clearance >80 mL · min −1 · 1.73 m −2 ). Sixty-three children had primary hypertension, 40 had secondary hypertension, and 22 had white-coat hypertension. Forty controls with normal blood pressure were recruited from the renal clinic. Uric acid levels were directly correlated with systolic ( r =0.80, P =0.0002) and diastolic ( r =0.66, P =0.0006) blood pressure in controls and in subjects with primary hypertension and were independent of renal function. Serum uric acid concentrations >5.5 mg/dL were found in 89% of subjects with primary hypertension, in 30% with secondary hypertension, in 0% with white-coat hypertension, and in 0% of controls. We conclude that serum uric acid is directly correlated with blood pressure in untreated children and that a serum uric acid value >5.5 mg/dL in an adolescent being evaluated for hypertension strongly suggests primary hypertension as opposed to white-coat or secondary hypertension. These results are consistent with the hypothesis that uric acid might have a role in the early pathogenesis of primary hypertension.