Journal of Isfahan Medical School

Journal of Isfahan Medical School

Evaluation of the Relationship between the Reduction of Serum Uric Acid Level and Control of Blood Pressure in Patients with Hypertension and Hyperuricemia

Document Type : Original Article (s)

Authors
Mohadeseh Pour-Pouneh 1
Rouhollah Narimani 1
Saeed Mardani 2
Ali Momeni 3
1 Resident, Department of Internal Medicine, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
2 Assistant Professor, Department of Internal Medicine, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
3 Associate Professor, Department of Internal Medicine, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
Abstract
Background: Hypertension is one of the most common diseases in the world causing mortality and morbidity; however it is not controlled well yet. Treatment of predisposing factors of hypertension can help to control this disease. Hyperuricemia is known as one of the risk factors of hypertension, but there are limited studies, whether reducing serum uric acid level can cause lowering high blood pressure or not. This study evaluated the effect of allopurinol -uric acid lowering drug- on uncontrolled hypertension in patients with hyperuricemia.Methods: This was a double-blind randomized clinical trial study on 50 patients with uncontrolled hypertension who also had hyperuricemia. After sex, age and body mass index (BMI) matching, the patients were divided to two groups: first group received 200 mg allopurinol daily and the second received placebo for two months. Systolic and diastolic blood pressure and serum uric acid level were measured at the start and end of study. Finally, the obtained data were analyzed using SPSS21 software.Findings: Allopurinol caused significant reduction in systolic (P = 0.0002) and diastolic (P = 0.0003) blood pressure. But, considering the age and sex, allopurinol is just significantly effective on lowering systolic and diastolic blood pressure in men older than 50 years, neither in men younger than 50 years nor in women.Conclusion: Treatment of hyperuricemia with allopurinol has positive effects on lowering blood pressure in men older than 50 years. It is not effective in men less than 50 years of age and in women.
Keywords
Hypertension
Hyperuricemia
Allopurinol
  1. Nasri H, Yazdani M. The relationship between serum LDL-cholesterol, HDL-cholesterol and systolic blood pressure in patients with type 2 diabetes. Kardiol Pol 2006; 64(12): 1364-8.
  2. Ghorbani A, Rafieian-Kopaei M, Nasri H. Lipoprotein (a): More than a bystander in the etiology of hypertension? A study on essential hypertensive patients not yet on treatment. J Nephropathol 2013; 2(1): 67-70.
  3. Baradaran A, Nasri H. Correlation of serum parathormone with hypertension in chronic renal failure patients treated with hemodialysis. Saudi J Kidney Dis Transpl 2005; 16(3): 288-92.
  4. Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA 2010; 303(20): 2043-50.
  5. Hasanpour Z, Nasri H, Rafieian-Kopaei M, Ahmadi A, Baradaran A, Nasri P, et al. Paradoxical effects of atorvastatin on renal tubular cells: an experimental investigation. Iran J Kidney Dis 2015; 9(3): 215-20.
  6. Behradmanesh S, Nasri H. Association of serum calcium with level of blood pressure in type 2 diabetic patients. J Nephropathol 2013; 2(4): 254-7.
  7. Nasri H, Behradmanesh S, Ahmadi A, Rafieian-Kopaei M. Impact of oral vitamin D (cholecalciferol) replacement therapy on blood pressure in type 2 diabetes patients; a randomized, double-blind, placebo controlled clinical trial. J Nephropathol 2014; 3(1): 29-33.
  8. Wright JD, Hughes JP, Ostchega Y, Yoon SS, Nwankwo T. Mean systolic and diastolic blood pressure in adults aged 18 and over in the United States, 2001-2008. Natl Health Stat Report 2011; (35): 1-22, 24.
  9. Kotchen TA. Hypertensive vascular disease. In: Longo D, Kasper D, Jameson L, Fauci A, Hauser S. Harrison's principles of internal medicine. New York, NY: McGraw-Hill; 2012. p. 2042-59.
  10. Lawes CM, Vander HS, Rodgers A. Global burden of blood-pressure-related disease, 2001. Lancet 2008; 371(9623): 1513-8.
  11. Greenland P, Knoll MD, Stamler J, Neaton JD, Dyer AR, Garside DB, et al. Major risk factors as antecedents of fatal and nonfatal coronary heart disease events. JAMA 2003; 290(7): 891-7.
  12. Nasri H. Association of serum leptin with anemia in maintenance hemodialysis patients. Saudi J Kidney Dis Transpl 2006; 17(4): 521-5.
  13. Rafieian-Kopaei M, Nasri H. Comment on: Is the renoprotective effect of erythropoietin in chronic kidney disease a myth? J Formos Med Assoc 2014; 113(1): 62.
  14. Said S, Hernandez GT. The link between chronic kidney disease and cardiovascular disease. J Nephropathol 2014; 3(3): 99-104.
  15. Nasri H. Serum leptin concentration and left ventricular hypertrophy and function in maintenance hemodialysis patients. Minerva Urol Nefrol 2006; 58(2): 189-93.
  16. . Rafieian-Kopaei M, Baradaran A. On the occasion of world diabetes day 2105; act today to change tomorrow. J Renal Endocrinol 2015; 1: e02.
  17. Nasri H, Ardalan MR. Chronic kidney disease and aging: The theme of world kidney day in 2014; nephrologist will become the professional geriatrist. J Res Med Sci 2014; 19(3): 198-9.
  18. Baradaran A, Nasri H. Helicobacter pylori specific IgG antibody and serum magnesium in type-2 diabetes mellitus chronic kidney disease patients. Saudi J Kidney Dis Transpl 2011; 22(2): 282-5.
  19. Gheissari A, Mehrasa P, Merrikhi A, Madihi Y. Acute kidney injury: A pediatric experience over 10 years at a tertiary care center. J Nephropathol 2012; 1(2): 101-8.
  20. Nasri H. World kidney day 2013: acute kidney injury; a public health aware. Iran J Public Health 2013; 42(3): 338-40.
  21. Lala MA, Nazar CMJ, Lala HA, Singh JK. Interrelation between blood pressure and diabetes. J Renal Endocrinol 2015; 1: e05.
  22. Baradaran A, Nasri H. Correlation of serum magnesium with serum parathormone levels in patients on regular hemodialysis. Saudi J Kidney Dis Transpl 2006; 17(3): 344-50.
  23. Nasri H. Serum C-reactive protein (CRP) in association with various nutritional parameters in maintenance hemodialysis patients. Bratisl Lek Listy 2005; 106(12): 390-5.
  24. Assadi F. Psychological impact of chronic kidney disease among children and adolescents: Not rare and not benign. J Nephropathol 2013; 2(1): 1-3.
  25. Rahimi Z, Moradi M, Nasri H. A systematic review of the role of renin angiotensin aldosterone system genes in diabetes mellitus, diabetic retinopathy and diabetic neuropathy. J Res Med Sci 2014; 19(11): 1090-8.
  26. Baradaran A, Nasri H, Rafieian-Kopaei M. Protection of renal tubular cells by antioxidants: current knowledge and new trends. Cell J 2015; 16(4): 568-71.
  27. Nasri H, Baradaran A. Close association between parathyroid hormone and left ventricular function and structure in end-stage renal failure patients under maintenance hemodialysis. Bratisl Lek Listy 2004; 105(10-11): 368-73.
  28. Bradran A, Nasri H. Association between white blood cell count and levels of serum homocysteine in end-stage renal failure patients treating with hemodialysis. J Ayub Med Coll Abbottabad 2006; 18(1): 22-6.
  29. Hajivandi A, Amiri M. World Kidney Day 2014: Kidney disease and elderly. J Parathyr Dis. 2014; 2(1): 3-4.
  30. Nasri H, Baradaran A. Correlation of serum magnesium with dyslipidemia in maintenance hemodialysis patients. Acta Medica (Hradec Kralove) 2004; 47(4): 263-5.
  31. Nasri H, Baradaran A. Association of serum lipoprotein(a) with ultrasonographically determined early atherosclerotic changes in the carotid and femoral arteries in kidney transplanted patients. Transplant Proc 2004; 36(9): 2683-6.
  32. Nasri H. The association between serum leptin and blood lymphocytes in hemodialysis patients. Bratisl Lek Listy 2007; 108(3): 122-7.
  33. Nasri H. Association of white blood cell count with left ventricular hypertrophy and ejection fraction in stable hemodialysis patients. Saudi J Kidney Dis Transpl 2007; 18(1): 31-6.
  34. Wang TJ, Vasan RS. Epidemiology of uncontrolled hypertension in the United States. Circulation 2005; 112(11): 1651-62.
  35. Victor RG, Leonard D, Hess P, Bhat DG, Jones J, Vaeth PA, et al. Factors associated with hypertension awareness, treatment, and control in Dallas County, Texas. Arch Intern Med 2008; 168(12): 1285-93.
  36. Gu Q, Paulose-Ram R, Dillon C, Burt V. Antihypertensive medication use among US adults with hypertension. Circulation 2006; 113(2): 213-21.
  37. Muntner P, Krousel-Wood M, Hyre AD, Stanley E, Cushman WC, Cutler JA, et al. Antihypertensive prescriptions for newly treated patients before and after the main antihypertensive and lipid-lowering treatment to prevent heart attack trial results and seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure guidelines. Hypertension 2009; 53(4): 617-23.
  38. Rouhi H, Ganji F. Effects of N-acetyl cysteine on serum lipoprotein (a) and proteinuria in type 2 diabetic patients. J Nephropathol 2013; 2(1): 61-6.
  39. Nasri H, Baradaran A. Aggravation of immunoglobulin a nephropathy by hyperuricemia: a mini-review on current findings and new concepts. Iran J Kidney Dis 2014; 8(5): 359-62.
  40. Muscelli E, Natali A, Bianchi S, Bigazzi R, Galvan AQ, Sironi AM, et al. Effect of insulin on renal sodium and uric acid handling in essential hypertension. Am J Hypertens 1996; 9(8): 746-52.
  41. Nasri H. Commentary on: Is uric acid an indicator of metabolic syndrome in the first-degree relatives of patients with type 2 diabetes? J Res Med Sci 2013; 18(3): 267-8.
  42. Nasri H, Ardalan MR, Rafieian-Kopaei M. On the occasion of world hypertension day 2014: A nephrology point of view. J Res Med Sci 2014; 19(9): 911-2.
  43. Cannon PJ, Stason WB, Demartini FE, Sommers SC, Laragh JH. Hyperuricemia in primary and renal hypertension. N Engl J Med 1966; 275(9): 457-64.
  44. Nasri H, Behradmanesh S, Ahmadi A, Baradaran A, Nasri P, Rafieian-Kopaei M. Association of serum lipids with level of blood pressure in type 2 diabetic patients. J Renal Inj Prev 2014; 3(2): 43-6.
  45. Khodadadi S. Role of herbal medicine in boosting immune system. Immunopathol Persa 2015; 1(1): e01.
  46. Mazzali M, Hughes J, Kim YG, Jefferson JA, Kang DH, Gordon KL, et al. Elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism. Hypertension 2001; 38(5): 1101-6.
  47. Ghaderian SB, Beladi-Mousavi SS. The role of diabetes mellitus and hypertension in chronic kidney disease. J Renal Inj Prev 2014; 3(4): 109-10.
  48. Behradmanesh S, Horestani MK, Baradaran A, Nasri H. Association of serum uric acid with proteinuria in type 2 diabetic patients. J Res Med Sci 2013; 18(1): 44-6.
  49. Beladi-Mousavi SS, Bashardoust B, Nasri H, Ahmadi A, Tolou-Ghamari Z, Hajian S, et al. The theme of the world diabetes day 2014; healthy living and diabetes; a nephrology view point. J Nephropharmacol 2014; 3(2): 43-5.
  50. Tamadon MR, Zahmatkesh M. World kidney day 2015. J Parathyr Dis 2015; 3(2): 34–6.
  51. Nasri H. Association of serum lipoprotein (a) with hypertension in diabetic patients. Saudi J Kidney Dis Transpl 2008; 19(3): 420-7.
  52. Ardalan MR, Nasri H. Acute kidney in- jury; the focus of world kidney day in 2013. J Nephropharmacol 2013; 2(2): 15-6.
  53. Kostka-Jeziorny K, Uruski P, Tykarski A. Effect of allopurinol on blood pressure and aortic compliance in hypertensive patients. Blood Press 2011; 20(2): 104-10.
  54. Soletsky B, Feig DI. Uric acid reduction rectifies prehypertension in obese adolescents. Hypertension 2012; 60(5): 1148-56.
  55. Feig DI, Johnson RJ. The role of uric acid in pediatric hypertension. J Ren Nutr 2007; 17(1): 79-83.
  56. Agarwal V, Hans N, Messerli FH. Effect of allopurinol on blood pressure: a systematic review and meta-analysis. J Clin Hypertens (Greenwich) 2013; 15(6): 435-42.
  57. Nasri H, Baradaran A, Shirzad H, Rafieian-Kopaei M. New concepts in nutraceuticals as alternative for pharmaceuticals. Int J Prev Med 2014; 5(12): 1487-99.
  58. Rafieian-Kopaei M, Behradmanesh S, Kheiri S, Nasri H. Association of serum uric acid with level of blood pressure in type 2 diabetic patients. Iran J Kidney Dis 2014; 8(2): 152-4.
  59. Mardani S, Nasri H, Rafieian-Kopaei M, Beladi Mousavi SS. Hyperuricemia; a new look at an old problem. J Nephropharmacol 2012; 1(2): 13-4.
  60. Rafieian-Kopaei M, Setorki M, Doudi M, Baradaran A, Nasri H. Atherosclerosis: process, indicators, risk factors and new hopes. Int J Prev Med 2014; 5(8): 927-46.
  61. Hajian S. Positive effect of antioxidants on immune system. Immunopathol Persa 2015; 1(1): e02.
Journal of Isfahan Medical School
Volume 33, Issue 353 - Serial Number 353
September and October 2015
Pages 1672-1685

  • Receive Date 24 June 2015
  • Accept Date 06 April 2022