The Association and Interaction Analysis of Hypertension and Uric Acid on Cardiovascular Autonomic Neuropathy

Overview

Journal J Endocrinol Invest

Publisher Springer

Specialty Endocrinology

Date 2015 Apr 24

PMID 25903694

Citations 4

Authors

X-P Liao

H-W Zhu

F Zeng

Z-H Tang

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study was to evaluate associations among hypertension (HTN) and uric acid (UA) with cardiovascular autonomic neuropathy (CAN), and to estimate the extent to which synergistic effects of HTN and UA affect the outcome in a Chinese population.

Method: We conducted a large-scale, population-based study to analyze the association and interaction of the two factors for CAN in a sample of 2092 Chinese people. Univariate and multiple linear regression (MLR) analysis were employed to detect these relationships. Interaction on an additive scale can be calculated by using the relative excess risk due to interaction (RERI), the proportion attributable to interaction (AP), and the synergy index (S).

Result: After adjusting for confounding factors, MLR showed that HTN was independently associated with CAN (P < 0.001). A significant interaction effect of UA and HTN on CAN was detected (P = 0.035; RETI = 1.483, 95 % CI 0.415-2.551; AP = 0.360, 95 % CI -0.043 to 0.76 and S = 1.908, 95 % CI 0.152-3.66).

Conclusion: Our findings suggest that HTN is independently and significantly associated with CAN and offer evidence to support the hypothesis that HTN and UA have interaction effects to influence the progression of CAN.

Citing Articles

Cardiovascular Autonomic Neuropathy and its Association with Cardiovascular and All-cause Mortality in Patients with End-stage Renal Disease.

Bokhari S, Inayat F, Jawa A, Virk H, Awais M, Hussain N Cureus. 2018; 10(8):e3243.

PMID: 30410849 PMC: 6214649. DOI: 10.7759/cureus.3243.

Cardiac Autonomic Neuropathy Predicts All-Cause and Cardiovascular Mortality in Patients With End-Stage Renal Failure: A 5-Year Prospective Study.

Doulgerakis D, Moyssakis I, Kapelios C, Eleftheriadou I, Chorepsima S, Michail S Kidney Int Rep. 2017; 2(4):686-694.

PMID: 29142986 PMC: 5678628. DOI: 10.1016/j.ekir.2017.03.002.

A study for association and interaction analysis to metabolic syndrome and the ESR1 gene on cardiovascular autonomic neuropathy in a Chinese Han population.

Zeng F, Zhou L, Tang Z Diabetol Metab Syndr. 2016; 8:42.

PMID: 27453734 PMC: 4957320. DOI: 10.1186/s13098-016-0155-3.

The analysis of blood pressure profiles and their severity in relation to diabetic cardiovascular autonomic neuropathy in the Chinese population: preliminary analysis.

Ge X, Chen H, Zhang K, Tang Z J Endocrinol Invest. 2016; 39(8):891-8.

PMID: 26940214 DOI: 10.1007/s40618-016-0444-6.

References

Iodice V, Low D, Vichayanrat E, Mathias C . Cardiovascular autonomic dysfunction in MSA and Parkinson's disease: similarities and differences. J Neurol Sci. 2011; 310(1-2):133-8. DOI: 10.1016/j.jns.2011.07.014. View

Kearney P, Whelton M, Reynolds K, Muntner P, Whelton P, He J . Global burden of hypertension: analysis of worldwide data. Lancet. 2005; 365(9455):217-23. DOI: 10.1016/S0140-6736(05)17741-1. View

Pafili K, Katsiki N, Mikhailidis D, Papanas N . Serum uric acid as a predictor of vascular complications in diabetes: an additional case for neuropathy. Acta Diabetol. 2014; 51(5):893-4. DOI: 10.1007/s00592-014-0631-x. View

Papanas N, Katsiki N, Papatheodorou K, Demetriou M, Papazoglou D, Gioka T . Peripheral neuropathy is associated with increased serum levels of uric acid in type 2 diabetes mellitus. Angiology. 2011; 62(4):291-5. DOI: 10.1177/0003319710394164. View

Ding W, Zhou L, Bao Y, Zhou L, Yang Y, Lu B . Autonomic nervous function and baroreflex sensitivity in hypertensive diabetic patients. Acta Cardiol. 2011; 66(4):465-70. DOI: 10.1080/ac.66.4.2126595. View

Tang Z, Zeng F, Yu X, Zhou L . Bayesian estimation of cardiovascular autonomic neuropathy diagnostic test based on baroreflex sensitivity in the absence of a gold standard. Int J Cardiol. 2013; 171(3):e78-80. DOI: 10.1016/j.ijcard.2013.11.100. View

Lefrandt J, Smit A, Zeebregts C, Gans R, Hoogenberg K . Autonomic dysfunction in diabetes: a consequence of cardiovascular damage. Curr Diabetes Rev. 2010; 6(6):348-58. DOI: 10.2174/157339910793499128. View

Tahrani A, Dubb K, Raymond N, Begum S, Altaf Q, Sadiqi H . Cardiac autonomic neuropathy predicts renal function decline in patients with type 2 diabetes: a cohort study. Diabetologia. 2014; 57(6):1249-56. DOI: 10.1007/s00125-014-3211-2. View

Bian R, Lou Q, Gu L, Kong A, So W, Ko G . Delayed gastric emptying is related to cardiovascular autonomic neuropathy in Chinese patients with type 2 diabetes. Acta Gastroenterol Belg. 2011; 74(1):28-33. View

10.

Baldasseroni S, Urso R, Maggioni A, Orso F, Fabbri G, Marchionni N . Prognostic significance of serum uric acid in outpatients with chronic heart failure is complex and related to body mass index: data from the IN-CHF Registry. Nutr Metab Cardiovasc Dis. 2011; 22(5):442-8. DOI: 10.1016/j.numecd.2010.08.007. View

11.

Erden M, Kocaman S, Poyraz F, Topal S, Sahinarslan A, Boyaci B . Incremental effects of serum uric acid levels, autonomic dysfunction, and low-grade inflammation on nocturnal blood pressure in untreated hypertensive patients and normotensive individuals. Turk Kardiyol Dern Ars. 2011; 39(7):531-9. DOI: 10.5543/tkda.2011.01545. View

12.

Spallone V, Ziegler D, Freeman R, Bernardi L, Frontoni S, Pop-Busui R . Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis, and management. Diabetes Metab Res Rev. 2011; 27(7):639-53. DOI: 10.1002/dmrr.1239. View

13.

Zeng F, Tang Z, Li Z, Yu X, Zhou L . Normative reference of short-term heart rate variability and estimation of cardiovascular autonomic neuropathy prevalence in Chinese people. J Endocrinol Invest. 2014; 37(4):385-91. DOI: 10.1007/s40618-013-0047-4. View

14.

Garruti G, Giampetruzzi F, Vita M, Pellegrini F, Lagioia P, Stefanelli G . Links between metabolic syndrome and cardiovascular autonomic dysfunction. Exp Diabetes Res. 2012; 2012:615835. PMC: 3312199. DOI: 10.1155/2012/615835. View

15.

Kiani J, Habibi Z, Tajziehchi A, Moghimbeigi A, Dehghan A, Azizkhani H . Association between serum uric acid level and diabetic peripheral neuropathy (A case control study). Caspian J Intern Med. 2014; 5(1):17-21. PMC: 3894465. View

16.

Lewington S, Clarke R, Qizilbash N, Peto R, Collins R . Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002; 360(9349):1903-13. DOI: 10.1016/s0140-6736(02)11911-8. View

17.

Schabath M, Spitz M, Delclos G, Gunn G, Whitehead L, Wu X . Association between asbestos exposure, cigarette smoking, myeloperoxidase (MPO) genotypes, and lung cancer risk. Am J Ind Med. 2002; 42(1):29-37. DOI: 10.1002/ajim.10084. View

18.

Hazari M, Khan R, Reddy B, Hassan M . Cardiovascular autonomic dysfunction in type 2 diabetes mellitus and essential hypertension in a South Indian population. Neurosciences (Riyadh). 2012; 17(2):173-5. View

19.

Assoumou H, Pichot V, Barthelemy J, Dauphinot V, Celle S, Gosse P . Metabolic syndrome and short-term and long-term heart rate variability in elderly free of clinical cardiovascular disease: the PROOF study. Rejuvenation Res. 2010; 13(6):653-63. DOI: 10.1089/rej.2010.1019. View

20.

Lakka H, Laaksonen D, Lakka T, Niskanen L, Kumpusalo E, Tuomilehto J . The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002; 288(21):2709-16. DOI: 10.1001/jama.288.21.2709. View