Hyperuricemia and coronary heart disease mortality: a meta-analysis of prospective cohort studies

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allopurinol 4 endocrinologydiseasesdrugs
diabetes mellitus 1 endocrinologydiseases
hyperlipidemia 2 endocrinologydiseases
hyperuricemia 39 endocrinologydiseases
metabolic syndrome 1 endocrinologydiseases

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allopurinol 24234 frequently used in hyperuricemic patients to reduce the SUA level. A meta-analysis of 10 studies showed that allopurinol is associated with a small but significant reduction in blood pressure [[56]]. High-dose allopurinol
allopurinol 24335 allopurinol is associated with a small but significant reduction in blood pressure [[56]]. High-dose allopurinol therapy may prolong the time to chest pain during exercise and improve endothelial dysfunction in patients
allopurinol 24507 and improve endothelial dysfunction in patients with stable angina pectoris [[57]]. These effects of allopurinol may be valuable for reducing future cardiovascular mortality. Encouragingly, a prospective cohort study
allopurinol 24666 cardiovascular mortality. Encouragingly, a prospective cohort study (n = 7135) demonstrated that high-dose allopurinol treatment is associated with a lower risk of cardiovascular events and mortality [[58]]. Although previous
Select Disease Character Offset Disease Term Instance
diabetes mellitus 13681 acute myocardial infraction, BMI body mass index, BP blood pressure, CHA Chicago Heart Association, DM diabetes mellitus , DBP diastolic blood pressure, ECG electrocardiograph, e-GFR estimated-glomerular filtration rate, HDL
hyperlipidemia 2084 and has a high mortality rate. Many traditional risk factors for CHD have been identified, such as hyperlipidemia , hypertension, diabetes, and smoking. Serum uric acid (SUA), the end product of purine metabolism via
hyperlipidemia 18436 risk of all-cause mortality was greater for women.Hyperuricemia has been correlated with hypertension, hyperlipidemia , diabetes, metabolic syndrome and renal disease, all of which could contribute to increased CHD and
hyperuricemia 536 prospective studies are conflicting. The objective of this study was to assess the association between hyperuricemia and risk of CHD mortality by performing a meta-analysis.MethodsPubmed and Embase were searched for relevant
hyperuricemia 789 published until July 2015. Studies were included only if they reported data on CHD mortality related to hyperuricemia in a general population. The pooled adjusted relative risk (RR) was calculated using a random-effects
hyperuricemia 1332 all-cause mortality increased by 20 and 9 %, respectively. According to the gender subgroup analyses, hyperuricemia increased the risk of CHD mortality in women (RR: 1.47; 95 % CI: 1.21–1.73) compared to men (RR:
hyperuricemia 2630 [[4], [8], [11], [12]] demonstrated that elevated SUA has a predictive value for CHD risk and that hyperuricemia may be an important causal factor for CHD mortality. However, other studies [[5], [6], [13]–[15]]
hyperuricemia 3136 weight index and other potential confounding factors, under- or over -estimate the association between hyperuricemia and the risk of related disease.However, regardless of whether hyperuricemia is a causal risk factor
hyperuricemia 3213 the association between hyperuricemia and the risk of related disease.However, regardless of whether hyperuricemia is a causal risk factor for CHD mortality, several pathophysiological mechanisms have been postulated
hyperuricemia 3509 with possible beneficial anti-atherosclerotic effects in the early years. However, for patients with hyperuricemia , elevated SUA may have a more negative role by stimulating oxidative stress and causing endothelial
hyperuricemia 3764 [[16]]. Moreover, the formation of oxygen free radicals and platelet adhesiveness are also induced by hyperuricemia [[17]]. These observations may explain some direct or indirect associations between hyperuricemia and
hyperuricemia 3862 by hyperuricemia [[17]]. These observations may explain some direct or indirect associations between hyperuricemia and CHD.A previous meta-analysis [[18]] suggested that hyperuricemia is associated with the risk of
hyperuricemia 3931 indirect associations between hyperuricemia and CHD.A previous meta-analysis [[18]] suggested that hyperuricemia is associated with the risk of CHD mortality and that the association was stronger in women than men.
hyperuricemia 4538 the previous meta-analysis was conducted. To accurately and comprehensively estimate the influence of hyperuricemia on CHD mortality in general populations, we performed an updated meta-analysis.MethodsLiterature searchWe
hyperuricemia 4797 search in Pubmed and Embase for relevant prospective cohort studies assessing the association between hyperuricemia and CHD mortality. The search covered from the date of inception until July 2015, and there was no language
hyperuricemia 4960 date of inception until July 2015, and there was no language restriction. The searched terms included hyperuricemia , uric acid, coronary disease, coronary heart disease, coronary artery disease, cardiac heart disease,
hyperuricemia 5519 were included: 1) a prospective cohort study of adult subjects; 2) described the association between hyperuricemia and CHD mortality; 3) an inception cohort involving adults without CHD; and 4) reported adjusted risk
hyperuricemia 6070 publication year, geographical location, sample size, gender, age, duration of follow-up, definition of hyperuricemia , outcome definition, adjusted risk estimates regarding CHD and all-cause mortality, and confounding
hyperuricemia 6265 mortality, and confounding variables. The primary outcome was the risk estimate for the association between hyperuricemia and CHD mortality. The quality of selected studies was evaluated using the Newcastle-Ottawa Scale [[20]].
hyperuricemia 6948 converted it from μmol/L to mg/dl by dividing by 59.48. If a study reported the association between hyperuricemia and CHD mortality according to an age- or SUA level-specific category, each was included in the meta-analysis.
hyperuricemia 9591 [[23], [25], [28]–[30]] included only men, and two [[21], [31]] included only women. The definition of hyperuricemia ranged from 5.6 to 7.0 mg/dl in men and from 5.4 to 7.0 mg/dl in women. Two studies reported the results
hyperuricemia 9726 7.0 mg/dl in men and from 5.4 to 7.0 mg/dl in women. Two studies reported the results of RR between hyperuricemia and CHD mortality based on the SUA level [[23]] and age [[21]] subgroup. Ten studies [[23]–[25], [27]–[31],
hyperuricemia 10215 represented it both ways. Nine studies [[21], [23]–[28], [32], [33]] reported the association between hyperuricemia and all-cause mortality. The majority of studies defined CHD mortality using the International Classification
hyperuricemia 14827 studies with respect to outcomes (I2 = 0.0 %, 3.9 %).Fig. 2Forest plot of association between hyperuricemia and coronary heart disease mortalityFor each increase of 1 mg/dl in the SUA level, the pooled adjusted
hyperuricemia 17145 heterogeneity among the seven studies may be related to gender.Fig. 4Forest plot of association between hyperuricemia and all-cause mortalityFor each increase of 1 mg/dl in the SUA level, the pooled adjusted RR for all-cause
hyperuricemia 17900 than region, follow-up duration and sample size.DiscussionOur updated meta-analysis demonstrates that hyperuricemia is associated with a modest but statistically significant increased risk of CHD and all-cause mortality.
hyperuricemia 18185 all-cause mortality increased by 20 and 9 %, respectively. According to gender subgroup analyses, hyperuricemia increased the risk of CHD mortality in women (RR: 1.47; 95 % CI: 1.21–1.73) compared to men (RR:
hyperuricemia 18726 [8], [13], [14], [21]–[37]] have provided conflicting evidence regarding the association between hyperuricemia and CHD or all-cause mortality; therefore, whether hyperuricemia is an independent risk and causal factor
hyperuricemia 18791 regarding the association between hyperuricemia and CHD or all-cause mortality; therefore, whether hyperuricemia is an independent risk and causal factor for CHD mortality remains unclear. This phenomenon may be related
hyperuricemia 18974 unclear. This phenomenon may be related to the differences in the enrolled populations, definition of hyperuricemia , outcomes studied, follow-up duration, sample size and statistical adjustment.To further investigate
hyperuricemia 19113 follow-up duration, sample size and statistical adjustment.To further investigate the association between hyperuricemia and CHD or all-cause mortality, Zhao et al. [[38]] and Kim et al. [[18]] assessed it using a meta-analysis.
hyperuricemia 19568 mortality was more pronounced in women (RR: 1.35; 95 % CI: 1.06–1.72). However, the association between hyperuricemia and CHD mortality was not assessed independently. Our meta-analysis suggests that hyperuricemia is associated
hyperuricemia 19664 between hyperuricemia and CHD mortality was not assessed independently. Our meta-analysis suggests that hyperuricemia is associated with all-cause mortality in both genders (Fig. 4), whereas Zhao et al. only observed
hyperuricemia 20069 an inception cohort involving adults without CHD. In the other study, Kim et al. demonstrated that hyperuricemia was associated with an increased risk of CHD mortality (RR 1.16; 95 % CI 1.01–1.30), similar to our
hyperuricemia 22379 evidence suggests the following possible mechanisms. First, several studies [[41]–[45]] suggested that hyperuricemia has a pathogenic role and predictive value in the development of hypertension. Therefore, a causal link
hyperuricemia 22623 hypertension is a plausible explanation for the possible increased cardiovascular risk in patients with hyperuricemia [[46]]. Second, increased SUA levels may encourage lipid peroxidation and promote the oxidation of low-density
hyperuricemia 23102 walls, researchers propose that SUA may have a direct role in the atherosclerosis process [[50]]. Third, hyperuricemia may induce endothelial dysfunction, which is predicted to promote the early development of atherosclerosis
hyperuricemia 23471 injure the vascular intima and ultimately activating the platelet and blood coagulation system. Finally, hyperuricemia also promotes thrombosis [[52], [53]] and activates monocyte chemotactic protein-1 [[46]], an important
hyperuricemia 23796 cardiovascular outcomes. Hyperuricemia is frequently encountered in hypertensive patients. Patients with hyperuricemia and hypertension are associated with a 3- to 5-fold increase in CHD compared to patients with normal
hyperuricemia 25666 with normal eGFR are needed to conduct in the future, only by this, the causal relationship between hyperuricemia and risk of CHD mortality could be accurately detected. Second, our results may be less convincing because
hyperuricemia 27205 [31]] that we included. Because of this, our statistical subgroup analyses suggested that regardless of hyperuricemia or an increase of 1 mg/dl in the SUA level, both are associated with CHD mortality in both genders.
hyperuricemia 27530 explore the impact of the study characteristics.ConclusionsIn conclusion, our meta-analysis suggests that hyperuricemia may modestly increase the risk of CHD and all-cause mortality. Because there are safe and effective
metabolic syndrome 18462 was greater for women.Hyperuricemia has been correlated with hypertension, hyperlipidemia, diabetes, metabolic syndrome and renal disease, all of which could contribute to increased CHD and all-cause mortality. Over the

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