Long-Term Follow-up of Patients with Hypertensive Disease Treated with Guanethidine

Sixty-three hypertensive patients treated with guanethidine, usually in conjunction with chlorthalidone, were followed up for periods as long as 2½ years. The guanethidine dosage was not found to be related to the size of the patient, duration of hypertension or its severity. Two patients developed intolerable syncope without satisfactory control of blood pressure. No aggravation of bronchitis or diabetes was observed. Faintness and diarrhea occasioned by the drug lessened with time. Symptomatic improvement was noted in the majority, as was improvement in the optic fundus, the electrocardiogram and the heart size. Four deaths were unrelated to therapy, but were the result of complications of underlying vascular disease.     

Effects of Losartan/Hydrochlorothiazide on Serum Uric Acid Levels and Blood Pressure in Hypertensive Patients

The effect of a mixed formulation of 50 mg losartan (LOS) and 12.5 mg hydrochlorothiazide (HCTZ) on blood pressure and the uric acid metabolism was analyzed in 73 patients who switched to this formulation from other antihypertensive drugs. Eight patients who switched to the formulation from the regular dose of renin-angiotensin (RA) inhibitor (angiotensin receptor blocker [ARB] or angiotensin-converting enzyme [ACE] inhibitor) only showed a significant decrease in blood pressure, from 156.9 ± 14.1/88.6 ± 9.7 mmHg to 128.3 ± 16.0/76.1 ±10.7 mmHg (p = 0.007), and a significant increase in serum uric acid levels, from 5.2 ± 1.1 mg/dL to 6.8 ± 0.7 mg/dL (p = 0.02). In the other 50 patients who switched from a combination of the regular dose of RA inhibitor and calcium channel blocker (CCB), their blood pressure significantly increased, from 126.0 ± 13.8/72.0 ± 10.0 mmHg to 132.5 ± 16.4/76.5 ± 11.3 mmHg (p = 0.02), and their serum uric acid levels also significantly increased, from 5.6 ± 1.1 mg/dL to 6.1 ± 1.3 mg/dL (p = 0.0002). Considering that guidelines recommend using antihypertensive therapies that do not lead to an increase in serum uric acid levels, we conclude that using the ARB/HCTZ combination is less suitable than the regular dose of the ARB/CCB combination due to its effect on hypertension and serum uric acid levels.     

The Effects of Oral Salicylate on Serum Uric Acid Levels

Thirteen males and six females were given 40 grains of oral salicylate daily for six days. The serum uric acid of 16 of the 19 subjects fell, the mean post-treatment level being 1.1 mg. % less than the control mean. In five males and five females, administration of 20 grains of oral salicylate daily for six days resulted in a uniform rise of serum uric acid, the post-treatment mean being 1.4 mg. % above the pretreatment mean. Salicylate therapy in common dosage may therefore falsely elevate or depress serum uric acid levels. An accurate evaluation of a serum uric acid level can be made only if the patient is not under the influence of salicylates.     

Altered Serum Selenium and Uric Acid Levels and Dyslipidemia in Hemodialysis Patients Could be Associated with Enhanced Cardiovascular Risk

In the present study, the first objective was to follow up serum selenium (Se) concentrations in 117 hemodialysis patients (HPs) during a 2-year longitudinal study, relating concentrations to biochemical indexes (n?=?6; namely lipoprotein profile, uric acid, and total protein levels). It was also evaluated whether the disease is associated with an enhanced cardiovascular risk. A healthy control group (n?=?50) was also studied. Mean serum Se levels were significantly lower in HPs than in the controls (p?=?0.002); mean levels significantly increased from the first to third blood sampling (p?相似文献   

Serum Uric Acid Levels and Risk of Metabolic Syndrome in Healthy Adults

ObjectiveTo investigate the relationship between hyperuricemia and metabolic syndrome in a population of healthy subjects.MethodsWe studied 1,573 healthy adults (25 to 64 years old) in the population laboratory of the Tehran University of Medical Sciences. The study was designed according to the World Health Organization MONICA (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease) project with use of the National Cholesterol Education Program Adult Treatment Panel III criteria for metabolic syndrome.ResultsThe crude prevalence of the metabolic syndrome was 29.9% (age-adjusted, 27.5%). The rate of metabolic syndrome significantly increased in higher quartiles of serum uric acid in both sexes but especially in women (P < .0001 versus P = .026). The bivariate correlation was significant between uric acid levels and age, total serum cholesterol, high-density lipoprotein cholesterol, triglycerides, body mass index, waist and hip circumferences, waist-to-hip ratio, and systolic and diastolic blood pressures; however, there was not a significant correlation between serum uric acid concentrations and fasting plasma glucose.ConclusionThese data indicate that an independent relationship exists between hyperuricemia and the metabolic syndrome. Moreover, hyperuricemia is significantly correlated with hypertriglyceridemia, hypertension, and visceral obesity. Early detection of hyperuricemia seems to be essential for prevention of the metabolic syndrome. (Endocr Pract. 2008;14:298-304)     

溃疡性结肠炎患者血清总胆红素和尿酸水平与炎性因子的相关性研究

摘要 目的：探讨溃疡性结肠炎（UC）患者血清总胆红素（STB）和尿酸（UA）与炎症因子之间的相关性。方法：选取2015年6月至2019年5月于我院确诊为UC的患者90例（UC组）和体检中心的健康体检人员90例（对照组）作为研究对象,UC组按Truelove-Witts病情程度分级标准和Mayo评分分组,采用全自动生化仪检测研究对象STB和UA水平,采用酶联免疫吸附试验检测研究对象血清中的肿瘤坏死因子-α（TNF-α）、白介素1β（IL-1β）和白介素6（IL-6）的水平,分析STB和UA水平与血清炎症因子水平、病情严重程度和Mayo评分的关系。结果：STB在UC组的水平低于对照组（P<0.05）,UC重度患者STB水平低于轻度、中度患者（P<0.05）,STB水平随着病情严重程度和Mayo评分增加而降低（P<0.05）;血清UA、TNF-α、IL-1β和IL-6在UC组的水平高于对照组（P<0.05）,并且随着病情严重程度和Mayo评分增加而升高（P<0.05）;STB水平与炎症因子（TNF-α、IL-1β和IL-6）水平、病情严重程度和Mayo评分均呈负相关（P<0.05）,血清UA水平与炎症因子（TNF-α、IL-1β和IL-6）水平、病情严重程度和Mayo评分均呈正相关（P<0.05）。结论：STB和UA在UC患者中异常表达,可能参与了UC的炎性反应过程,二者均与病情有关,可以用来辅助评估UC的病情严重程度。     

Serum Uric Acid Is Associated with Left Ventricular Hypertrophy Independent of Serum Parathyroid Hormone in Male Cardiac Patients

Background

Several studies have shown that serum uric acid (UA) is associated with left ventricular (LV) hypertrophy. Serum levels of parathyroid hormone (PTH), which has bbe shown to be correlated with UA, is also known to be associated with cardiac hypertrophy; however, whether the association between UA and cardiac hypertrophy is independent of PTH remains unknown.

Purpose

We investigated whether the relationship between serum uric acid (UA) and LV hypertrophy is independent of intact PTH and other calcium-phosphate metabolism-related factors in cardiac patients.

Methods and Results

In a retrospective study, the association between UA and left ventricular mass index was assessed among 116 male cardiac patients (mean age 65±12 years) who were not taking UA lowering drugs. The median UA value was 5.9 mg/dL. Neither age nor body mass index differed significantly among the UA quartile groups. Patients with higher UA levels were more likely to be taking loop diuretics. UA showed a significant correlation with intact PTH (R = 0.34, P<0.001) but not with other calcium-phosphate metabolism-related factors. Linear regression analysis showed that log-transformed UA showed a significant association with left ventricular mass index, and this relationship was found to be significant exclusively in patients who were not taking loop and/or thiazide diuretics. Multivariate logistic regression analysis showed that log-transformed UA was independently associated with LV hypertrophy with an odds ratio of 2.79 (95% confidence interval 1.48–5.28, P = 0.002 per one standard deviation increase).

Conclusions

Among cardiac patients, serum UA was associated with LV hypertrophy, and this relationship was, at least in part, independent of intact PTH levels, which showed a significant correlation with UA in the same population.     

老年高血压合并2 型糖尿病患者血清同型半胱氨酸、血尿酸水平 变化及临床意义

目的：探讨老年高血压合并2 型糖尿病患者血清同型半胱氨酸（Homocysteine, Hcy）、血尿酸（Serum uric acid, SUA）水平变 化及其临床意义。方法：2012 年9 月至2013 年9 月期间,我院诊治的40 例单纯高血压和40 例高血压合并2 型糖尿病患者,分别 作为对照组和研究组,检测两组血清Hcy、SUA水平。结果：两组患者收缩压、舒张压比较无统计学差异（P>0.05）。研究组空腹血 糖、餐后2h 血糖、血清Hcy、SUA 均显著高于对照组（P<0.05）。研究组中血管并发症患者血清Hcy、SUA为（25.0± 5.0）umol/L 和 （390.0± 65.0）mmol/L显著高于无血管并发症患者（17.0± 4.0）umol/L 和（330.0± 55.0）mmol/L,血管并发症患者FBG、餐后2h 血 糖与无血管并发症患者比较无统计学差异（P>0.05）。结论：高血压合并2 型糖尿病患者血清Hcy、SUA异常升高,且存在慢性血 管并发症患者两者水平更高,血清Hcy、SUA是老年高血压合并2 型糖尿病的危险因素。     

老年高血压合并2型糖尿病患者血清同型半胱氨酸、血尿酸水平变化及临床意义

目的：探讨老年高血压合并2型糖尿病患者血清同型半胱氨酸（Homocysteine,Hcy）、血尿酸（Serum uric acid,SUA）水平变化及其临床意义。方法：2012年9月至2013年9月期间,我院诊治的40例单纯高血压和40例高血压合并2型糖尿病患者,分别作为对照组和研究组,检测两组血清Hcy、SUA水平。结果：两组患者收缩压、舒张压比较无统计学差异（P〉0.05）。研究组空腹血糖、餐后2h血糖、血清Hcy、SUA均显著高于对照组（P〈0.05）。研究组中血管并发症患者血清Hcy、SUA为（25.0±5.0）μmol/L和（390.0±65.0）mmol/L显著高于无血管并发症患者（17.0±4.0）μmol/L和（330.0±55.0）mmol/L,血管并发症患者FBG、餐后2h血糖与无血管并发症患者比较无统计学差异（P〉0.05）。结论：高血压合并2型糖尿病患者血清Hcy、SUA异常升高,且存在慢性血管并发症患者两者水平更高,血清Hcy、SUA是老年高血压合并2型糖尿病的危险因素。     

Effects of Three Strong Statins (Atorvastatin,Pitavastatin, and Rosuvastatin) on Serum Uric Acid Levels in Dyslipidemic Patients

We have retrospectively investigated the effects of three strong statins, atorvastatin, pitavastatin, and rosuvastatin, on serum uric acid (SUA) levels. SUA levels after a few months of statin treatment were compared with those before treatment in 150 outpatients with dyslipidemia. In the atorvastatin (n = 62) and rosuvastatin (n = 45) groups, the SUA levels were reduced by 6.5% (p < 0.0001) and 3.6% (p = 0.03) respectively, but in the pitavastatin group (n = 43), the SUA level increased by 3.7% (p = 0.38). Because uric acid is considered a risk factor for cardiovascular disorders, atorvastatin or rosuvastatin treatment may be recommended when statins are used in patients at high risk for cardiovascular disorders complicated with hyperuricemia.     

脑小血管病患者血清尿酸水平和步态障碍之间的相关性

目的:探讨脑小血管病(Cerebral small vessel disease,CSVD)患者血清尿酸(Uric acid,UA)水平和步态障碍之间的相关性。方法:将我院自2018年1月至2019年1月收治的CSVD患者172例作为研究对象,根据患者血清尿酸水平分为研究组87例,对照组85例。收集和比较两组的临床资料,使用Logistic回归分析血清尿酸和CSVD患者脑室旁、深部白质高信号、步态障碍之间的相关性。结果:两组的年龄、性别、体质指数、血糖指标、血脂指标水平,合并高血压、糖尿病病史和吸烟情况比较差异无统计学意义(P0.05)。研究组血清尿酸水平、饮酒患者比例明显高于对照组(P0.05),脑室旁高信号和深部白质高信号中重度比例均明显高于对照组(P0.05);将步态障碍、脑室旁高信号与深部白质高信号作为影响因素带入相关分析,结果显示血清尿酸水平与步态障碍、脑室旁高信号与深部白质高信号比较存在正相关(P0.05)。结论:CSVD患者血清高尿酸水平与脑室旁、深部白质高信号病变程度呈明显的正相关性,也是患者步态障碍的影响因素。     

Serum Uric Acid Levels of Healthy Caucasian,Chinese and Haida Indian Males in British Columbia

Because previous studies have shown that serum uric acid levels are higher in members of the Filipino and Maori races than in Caucasians, and because gout seemed unexpectedly common in the Chinese population of Vancouver, a study of serum uric acid levels in Caucasian, Chinese and Haida Indian males was undertaken. The serum uric acid levels of 200 Caucasian, 100 Chinese and 237 Haida Indian males were determined by the ultraviolet spectrophotometric method of Dubbs, which gives a result 0.5 mg. % below that of the more commonly employed method of Grayzel. The mean level of the Caucasians was 4.55 mg. % and that of the Haida Indians 4.41 mg. %; in contrast, the Chinese mean was 5.44 mg. %, a significantly higher figure than the means of the other two groups. No explanation for this finding can be given at present.     

血清尿酸水平与老年轻度高血压患者的内皮功能相关性分析

目的:探讨血清尿酸水平与老年轻度高血压患者的内皮功能相关性。方法:选取我院2020年1月到2020年12月共收治的200例老年轻度高血压患者作为研究对象,所有患者均为未使用过降压药物治疗,将其分为轻度高血压组。另选取同期收治的200例高血压常规药物治疗患者作为重度高血压组与200名健康者作为对照组,对比三组患者血清尿酸水平与血管内皮功能。对观察组所有患者依照血清尿酸水平进行分组,将血清尿酸水平208-360μmol/L的患者分为低尿酸组,共计136例,将血清尿酸水平≥360μmol/L的患者分为高尿酸组,共计64例。对比两组患者的一般临床指标、血管内皮功能与氧化应激指标,并分析血清尿酸水平与老年轻度高血压患者的内皮功能相关性。结果:重度、轻度高血压组与对照组患者NO、ET-1、SUA水平对比差异显著,具有统计学意义(P<0.05);高尿酸组与低尿酸组患者TG、TC、DBP、SBP水平对比无明显差异(P>0.05),高尿酸组患者Cr水平高于低尿酸组,组间对比,差异具有统计学意义(P<0.05);高尿酸组与低尿酸组患者T-AOC、GSH-Px、LHP、MDA、NO、ET-1水平对比差异显著,高尿酸组患者LHP、MDA和ET-1水平明显高于低尿酸组,高尿酸组患者T-AOC、GSH-Px、NO水平明显低于低尿酸组,组间对比,差异具有统计学意义(P>0.05);Spearman相关分析结果显示:TG、TC、Cr、DBP、SBP与血尿酸水平无明显相关性(P>0.05),T-AOC、GSH-Px、NO与血清尿酸水平呈负相关(P<0.05),LHP、MDA、ET-1与血清尿酸水平呈正相关(P<0.05)。结论:血清尿酸水平与老年轻度高血压患者的内皮功能具有明显相关性,而且证明血尿酸水平的升高可能由患者氧化应激导致,因此氧化应激水平也是引起血管内皮功能障碍的一种潜在机制,希望本研究结果能够为高血压患者的疾病控制提供参考意见。     

Relationship between Inflammatory Cytokines and Uric Acid Levels with Adverse Cardiovascular Outcomes in Patients with Stable Coronary Heart Disease

Background

So far it is unclear whether the association between serum uric acid (SUA), inflammatory cytokines and risk of atherosclerosis is causal or an epiphenomenon. The aim of the project is to investigate the independent prognostic relationship of inflammatory markers and SUA levels with adverse cardiovascular outcomes in a patient population with stable coronary heart disease (CHD).

Methods

SUA, C-reactive protein (CRP) and interleukin (IL)-6 were measured at baseline in a cohort of 1,056 patients aged 30–70 years with CHD. Cox proportional hazards model was used to determine the prognostic value of these markers on a combined CVD endpoint during eight year follow-up after adjustment for covariates.

Results

For 1,056 patients with stable coronary heart disease aged 30–70 years (mean age 58.9 years, SD 8.0) follow-up information and serum measurements were complete and n = 151 patients (incidence 21.1 per 1000 patients years) experienced a fatal or non-fatal CVD event during follow-up (p-value = 0.05 for quartiles of SUA, p = 0.002 for quartiles of CRP, p = 0.13 for quartiles of IL-6 in Kaplan-Meier analysis). After adjustment for age, gender and hospital site the hazard ratio (HR) for SUA increased from 1.37 to 1.65 and 2.27 in the second, third, and top quartile, when compared to the bottom one (p for trend <0.0005). The HR for CRP increased from 0.85 to 0.98 and 1.64 in the respective quartiles (p for trend 0.02). After further adjustment for covariates SUA still showed a clear statistically significant relationship with the outcome (p for trend 0.045), whereas CRP did not (p for trend 0.10).

Conclusion

The data suggest that compared to inflammatory markers such as CRP and IL-6 serum uric acid levels may predict future CVD risk in patients with stable CHD with a risk increase even at levels considered normal.     

Development of Extrapyramidal Symptoms in Hypertensive Patients Treated with Diazoxide

Extrapyramidal symptoms developed a variable time after the start of treatment with oral diazoxide in 15% of a series of 100 severely hypertensive patients. Six illustrative cases are described. Treatment with diazoxide could be continued in four of these. The symptoms are usually controllable either by dosage adjustment or by the use of diazepam or procyclidine. There was no evidence of irreversibility of the extrapyramidal syndromes observed.     

丹红注射液对急性脑梗死患者血尿酸与胆红素水平的影响

目的:探究丹红注射液对急性脑梗死患者血尿酸与胆红素水平的影响。方法:选取2015年2月到2016年2月我院神经内科收治的急性脑梗死患者96例,根据随机数字对照表分为对照组与试验组,每组各48例。对照组给予患者钙离子拮抗剂尼莫地平缓释片和抗血小板凝集剂阿斯匹林肠溶片治疗,试验组采用常规药物治疗联合给予丹红注射液治疗。观察并比较两组患者的临床疗效以及治疗前后血尿酸与胆红素水平的变化情况。结果:治疗后,两组患者的NIHSS评分及血尿酸与胆红素水平均较治疗前显著降低(P0.05),且与对照组相比,试验组的NIHSS评分及血尿酸与胆红素水平更低(P0.05)。结论:丹红注射液对急性脑梗死患者具有显著的治疗效果,推测可能与降低血尿酸与胆红素的水平有关。