Relationship between hyperuricemia and the risk of cardiovascular events and chronic kidney disease in both the general population and hypertensive patients: A systematic review and meta-analysis

Abstract

Background

To explore the relationships between hyperuricemia and the risk of cardiovascular diseases (CVD) and chronic kidney disease (CKD) in both the general population and hypertensive patients through meta-analysis.

Methods and results

We systematically searched PubMed, Embase, and Cochrane Library databases from January 2012. The eligibility criteria were predefined, and quality was assessed using the Newcastle-Ottawa Scale (NOS). Stata 15.1 was used for meta-analysis, heterogeneity and sensitivity analysis. Subgroup analysis was used to explore heterogeneity, funnel plots and Egger tests were used to assesse publication bias and applicability. A total of 10,662 studies were retrieved, 45 of which were included in this meta-analysis utilizing a random effects model. Hyperuricemia was significantly associated with an increased risk of new-onset hypertension (RR = 1.36, 95% CI 1.16–1.59; I² = 98.8%), total CVD (RR = 1.53, 95% CI 1.23–1.89; I² = 93.7%), stroke (RR = 1.97, 95% CI 1.71–2.26, I² = 0.0%), coronary heart disease (CHD) (RR = 1.56, 95% CI 1.06–2.30, I² = 93.3%), and CKD (RR = 1.71, 95% CI 1.56–1.87; I² = 87.3%). However, subgroup analysis showed no significant associations between hyperuricemia and hypertension in non-Asian populations (RR = 0.88, 95% CI 0.59–1.33), or between hyperuricemia and CVD with a follow-up duration <5 years (RR = 1.26, 95% CI 0.97–1.63). Among hypertensive patients, hyperuricemia was significantly associated with total CVD (RR = 2.32, 95% CI 1.31–4.12, I² = 90.2%), but not with stroke (RR = 1.48, 95% CI 0.86–2.55; I² = 90.7%) or CHD (RR = 1.51, 95% CI 0.98–2.33; I² = 71.7%).

Conclusion

Hyperuricemia was significantly associated with an increased risk of new-onset hypertension, total CVD, stroke, CHD, and CKD in the general population. Among hypertensive patients, hyperuricemia was associated with an increased risk of CVD but not stroke or CHD alone. Registration Number: CRD42022370692.