维克森林大学Baptist医学中心最近研究发现在非洲裔美国人中血尿酸水平升高与高血压具有较强相关性，这表明进行简单的血液检测就能预测发生高血压的风险，降低尿酸可能成为减少该人群高血压相关并发症的新的治疗方法。该研究结果发表在美国心脏病协会的《Hypertension》杂志上。
内科学副教授医学博士理学硕士Philip B. Mellen是该研究的领导者，他说：“我们的研究发现尿酸和高血压的相关性在黑人中更强，而黑人患肾脏疾病、中风和其他高血压并发症的比例也较高。”
尿酸水平受到饮食因素（例如高蛋白饮食）及体内细胞分解的影响。大部分尿酸从尿中排除。如果尿酸产生过多或者肾脏排泄尿酸的能力下降，就会导致血尿酸水平升高。
尿酸水平过高会引发痛风，但最近的动物和人体研究均显示，尿酸水平适度升高是引起高血压的原因之一。目前研究者正在进行降低尿酸是否可以预防高血压的相关研究。“如果研究显示降低尿酸可以有效治疗高血压，那么根据我们的研究结果，别嘌呤醇等降尿酸药物可能更适于黑人。” Mellen.说。
以前的研究发现高尿酸血症与高血压之间有关系，但是这些研究都没有包括足够数量的黑人。当前这项研究的数据来自ARIC研究（动脉粥样硬化风险的社区研究）。共有9104名参与者，年龄在45～64岁之间，平均年龄53岁。所有参与者在研究开始时均未患高血压，随访过程中每三年需接受四次以上体检明确有无高血压。统计分析显示，尿酸水平最高的四分值组高血压的发病风险增加约15％，调整了年龄、基础血压、体重指数、肾功能、糖尿病和吸烟等影响因素后结果仍是如此。尿酸和高血压的相关性在黑人男性中尤其明显。尿酸水平最高四分值组的男性黑人与最低四分值组的男性黑人相比，高血压的发病风险增加两倍。而在黑人妇女中，最高四分值组与最低四分值组相比，高血压的发病风险增加30％。
Mellen.说：“通过九年多的随访研究发现，血尿酸水平与高血压呈正相关，这种相关性在黑人中更加突出。目前还需要更多的研究来证实高尿酸的临床后果，尤其是在黑人当中。”
Source: Wake Forest University Baptist Medical Center
Date: November 3, 2006
Study Shows Strong Link Between Uric Acid And Hypertension In African Americans
New research shows that higher levels of uric acid are strongly associated with high blood pressure in African Americans, suggesting that a simple blood test could predict risk and that treatments to lower uric acid may be a novel way to reduce hypertension-related complications in this population.
"The novel angle of our study is that the association between uric acid and hypertension is much stronger in blacks, a group that disproportionately suffers from kidney disease, stroke and other complications of hypertension," said Philip B. Mellen, M.D., M.S., assistant professor internal medicine, and lead investigator.
The results are reported online in Hypertension, a journal of the American Heart Association.
Uric acid levels are influenced by dietary factors, such as high levels of protein, and by the breakdown of the body's cells. Most uric acid is eliminated in urine. However, if excess uric acid is being produced or if the kidneys cannot remove enough of it, levels build up in the blood.
Very high levels of uric acid cause gout, but recent animal and human studies suggest that modest elevations of uric acid are one cause of hypertension. Currently, studies are under way to evaluate whether lowering uric acid prevents hypertension.
"If these studies show that lowering uric acid is an effective treatment, our research suggests that it may be especially appropriate for blacks," said Mellen.
Uric acid can be lowered by medications such as allopurinol and newer agents under development.
Previous studies have linked high levels of uric acid and hypertension, but they did not include a large number of blacks. For the current study, researchers evaluated data from the Atherosclerosis Risk in Communities study.
The 9,104 participants were free of hypertension when the study began. They were evaluated for hypertension at three-year intervals over four examinations. At the start, participants were between 45 and 64 with a mean age of 53 years.
A statistical analysis revealed that overall, uric acid levels in the highest quartile increased the risk of hypertension by about 15 percent. These results held true even after adjusting for other variables that could have affected results, such as age, baseline blood pressure, body mass index, kidney function, diabetes and smoking.
The link between uric acid and hypertension was particularly strong among black men. Black men in the highest quartile had a two-fold risk of developing hypertension, compared to black men in the lowest quartile. In black women in the highest quartile, the increase in risk was 30 percent, compared to black women in the lowest quartile.
"Uric acid in the blood was positively associated with hypertension over nine years of follow-up, and this relationship was stronger in blacks than in whites," said Mellen. "More research is warranted concerning the clinical consequences of high uric acid, especially in blacks."
Co-researchers were: Anthony J. Bleyer, M.D., M.S., Gregory W. Evans, M.S., Lynne E. Wagenknecht, DrPH, and David M. Herrington, M.D., M.H.S., all with Wake Forest, and Thomas P. Erlinger, M.D., M.P.H., with University of Texas Medical Branch, F. Javier Nieto, M.D., Ph.D., University of Wisconsin, and Marion R. Wofford, M.D., M.P.H., University of Mississippi Medical Center.
编辑：蓝色幻想
