Serum uric acid as a predictor of future hypertension: Stratified analysis based on body mass index and age

Serum uric acid level is a predictor of future hypertension. However, its dependence on body mass index or age is unclear. We examined 26,442 Japanese males aged 18–60 years free from hypertension or diagnosed cardiovascular disease at baseline followed up between 2000 and 2010. Participants were categorized into three groups according to the tertile of serum uric acid levels [mg/dL; 1st (reference): 0.1–5.3; 2nd: 5.4–6.2; 3rd: 6.3–11.6]. Incident hypertension was defined as newly detected blood pressure ≥ 140/90 mm Hg and/or antihypertensive drugs initiation. Body mass index (< 25 kg/m2 vs. ≥ 25 kg/m2) and age (< 40 years vs. ≥ 40 years) were stratified into two groups. During a mean follow-up of 7.2 years, there were 11,361 (43%) hypertension cases. Mean serum uric acid levels (mg/dL) at baseline in each group were 1st tertile, 4.6; 2nd tertile, 5.8; and 3rd tertile, 7.0. The cumulative incident hypertension rate was significantly higher in the 3rd tertile (50.8%) than in the 1st (37.4%). Multiple-adjusted hazard ratios (95% confidence interval) for incident hypertension compared with 1st tertile were 1.01 (0.96–1.05) and 1.15 (1.10–1.21) in the 2nd and 3rd tertile, respectively. There was a significant interaction between age and serum uric acid level (p for interaction = 0.035). In subjects aged ≥ 40 years, the 3rd serum uric acid group showed higher hazard ratios [1.48 (1.38–1.59)]. High serum uric acid level was associated with future hypertension in young and middle-aged Japanese males. This association was stronger among subjects ≥ 40 years old.