Abstract P516: Arterial Stiffness is a Mediator of Uric Acid-related Development of Hypertension

Objectives: Uric acid (UA) is a risk for the development of hypertension, but the underlying mechanisms of this development has not been fully clarified. On the other hand, arterial stiffness is also noted as a risk for the development of hypertension. Then, the present prospective observational study examined whether UA is associated with the development of hypertension mediated by the increase of arterial stiffness. Methods and Results: In 3274 middle-aged Japanese men (aged 42 ± 9 years old) without hypertension at the study baseline, the brachial-ankle pulse wave velocity (baPWV), radial augmentation index (rAI), systolic and diastolic blood pressure (SBP/DBP) and serum UA level were measured annually over a 9-year period. During this study period, 474 subjects (14.5%) developed hypertension. Binary logistic regression analysis demonstrated that serum UA levels has a significant odds ratio for the development of hypertension even after the adjustment [1.3 (1.1-1.5), p<0.01]. Multivariate linear regression analysis also demonstrated that serum UA levels at the baseline of study period had a significant association with delta changes of SBP (beta=0.10 p<0.01), DBP (beta = 0.13, p<0.01) and baPWV (beta=1.12 p<0.01), but not that of rAI, during the study period. Mixed model linear regression analysis in repeated measurement data revealed the following: 1) At each annual measurement, higher serum UA levels were associated with a higher annual increase of the SBP (estimate=0.63 p<0.01), DBP (estimate=0.63 p<0.01) and baPWV (estimate=6.70 p<0.01). Mediation analysis demonstrated that baPWV had a significant indirect effect on the association of UA at the baseline with the delta change of SBP (indirect effect = 0.03 p<0.01). Conclusion: UA is a risk for the development of hypertension. In there, UA may elevate blood pressure via increase in arterial stiffness, at least in parts.