Objectives: In older individuals, the role of serum uric acid (SUA) as risk factor for mortality is debated. This study investigated the association of SUA with all-cause and cardiovascular (CV) mortality in older adults participating in the large multicentre observational uric acid right for heart health (URRAH) study. Methods: Eight thousand URRAH participants aged 65R were included in the analysis. The predictive role of SUA was assessed using Cox regression models stratified according to the cut-off age of 75. SUA was tested as continuous and categorical variable (age-specific quartiles). The prognostic threshold of SUA for mortality was analysed using receiver operating characteristic curves. Results: Among participants aged 65–74, multivariate Cox regression analysis adjusted for CV risk factors and comorbidities identified an independent association of SUA with both all-cause mortality (hazard ratio [HR] 1.169, 95% confidence interval [CI] 1.107–1.235) and CV mortality (HR 1.146, 95% CI 1.064–1.235). The cut-off value of 4.8mg/dl discriminated mortality status. In participants aged 75R, we observed a J-shaped relationship of SUA with all-cause and CV mortality, with risk increasing at extreme SUA levels. Conclusions: These results confirmed the predictive role of SUA for all-cause and CV mortality in older adults, while revealing considerable age-related differences. Mortality risk increased at higher SUA levels in participants aged 65–74, with a prognostic threshold of 4.8mg/dl. The relationship between SUA and mortality was J-shaped in oldest participants. Large interventional studies are needed to clarify the benefits and possible risks of urate-lowering treatments in older adults.

Ungar, A., Rivasi, G., Di Bari, M., Virdis, A., Casiglia, E., Masi, S., et al. (2022). The association of uric acid with mortality modifies at old age: Data from the uric acid right for heart health (URRAH) study. JOURNAL OF HYPERTENSION, 40(4 (april 2022)), 704-711 [10.1097/HJH.0000000000003068].

The association of uric acid with mortality modifies at old age: Data from the uric acid right for heart health (URRAH) study

Bombelli M.;Giannattasio C.;Maloberti A.;Parati G.;Quarti-Trevano F.;Tocci G.;Grassi G.;
2022

Abstract

Objectives: In older individuals, the role of serum uric acid (SUA) as risk factor for mortality is debated. This study investigated the association of SUA with all-cause and cardiovascular (CV) mortality in older adults participating in the large multicentre observational uric acid right for heart health (URRAH) study. Methods: Eight thousand URRAH participants aged 65R were included in the analysis. The predictive role of SUA was assessed using Cox regression models stratified according to the cut-off age of 75. SUA was tested as continuous and categorical variable (age-specific quartiles). The prognostic threshold of SUA for mortality was analysed using receiver operating characteristic curves. Results: Among participants aged 65–74, multivariate Cox regression analysis adjusted for CV risk factors and comorbidities identified an independent association of SUA with both all-cause mortality (hazard ratio [HR] 1.169, 95% confidence interval [CI] 1.107–1.235) and CV mortality (HR 1.146, 95% CI 1.064–1.235). The cut-off value of 4.8mg/dl discriminated mortality status. In participants aged 75R, we observed a J-shaped relationship of SUA with all-cause and CV mortality, with risk increasing at extreme SUA levels. Conclusions: These results confirmed the predictive role of SUA for all-cause and CV mortality in older adults, while revealing considerable age-related differences. Mortality risk increased at higher SUA levels in participants aged 65–74, with a prognostic threshold of 4.8mg/dl. The relationship between SUA and mortality was J-shaped in oldest participants. Large interventional studies are needed to clarify the benefits and possible risks of urate-lowering treatments in older adults.
Articolo in rivista - Articolo scientifico
cardiovascular prevention; cardiovascular risk; mortality; older adults; uric acid;
English
704
711
8
Ungar, A., Rivasi, G., Di Bari, M., Virdis, A., Casiglia, E., Masi, S., et al. (2022). The association of uric acid with mortality modifies at old age: Data from the uric acid right for heart health (URRAH) study. JOURNAL OF HYPERTENSION, 40(4 (april 2022)), 704-711 [10.1097/HJH.0000000000003068].
Ungar, A; Rivasi, G; Di Bari, M; Virdis, A; Casiglia, E; Masi, S; Mengozzi, A; Barbagallo, C; Bombelli, M; Bruno, B; Cicero, A; Cirillo, M; Cirillo, P; Desideri, G; D'Elia, L; Ferri, C; Galletti, F; Gesualdo, L; Giannattasio, C; Iaccarino, G; Ciccarelli, M; Lippa, L; Mallamaci, F; Maloberti, A; Mazza, A; Muiesan, M; Nazzaro, P; Palatini, P; Parati, G; Pontremoli, R; Quarti-Trevano, F; Rattazzi, M; Salvetti, M; Tikhonoff, V; Tocci, G; Cianci, R; Verdecchia, P; Viazzi, F; Volpe, M; Grassi, G; Borghi, C
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/357944
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