Published Online
on August 6, 2009

A more recent version of this article appeared on November 1, 2009

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Original Article

Hyperuricemia and Incident Heart Failure

Eswar Krishnan¹

Stanford University, Stanford, CA

^* Corresponding author; email: arthritis.md{at}gmail.com

Background—Hyperuricemia, a known correlate of oxidative stress, is a marker for adverse prognosis among individuals with heart failure. However, the relationship between hyperuricemia and the risk for incidence of heart failure in a community-based population has not been studied.

Methods and Results—We prospectively analyzed the relationship between serum uric acid concentration at baseline and subsequent heart failure among the participants of the Framingham Offspring cohort (mean baseline age 36 years, women 52%). Using Cox regressions we calculated the risk of heart failure with increasing serum uric acid after adjusting for sex, age, smoking, body mass index, renal dysfunction, diuretics, systolic blood pressure, valvular heart disease, diabetes, alcohol, and use of anti-hypertensive medications. The incidence rates of heart failure was ~6 fold higher among those at the highest quartile of serum uric acid (>6.3 mg/dl) compared to those at the lowest quartile (<3.4mg/dl). The adjusted hazard ratio for the highest quartile of serum uric acid compared to the lowest was 2.1 (1.04-4.22). The relationship between hyperuricemia and heart failure was found in participants without metabolic syndrome and other subgroups as well.

Conclusion—Hyperuricemia is a novel, independent, risk factor for heart failure in a group of young general community dwellers. This has implications for development of preventive strategies for heart failure.

Key Words: heart failure • risk • uric acid