Relationship between uric acid and left ventricular mass and geometry in Nigerian patients with untreated essential hypertension

Background: Hypertension is associated with left ventricular hypertrophy (LVH). Serum uric acid is often elevated in hypertension.Objective: To assess the relationship between serum uric acid and left ventricular mass and geometry in untreated patients with essential hypertension.Materials and Methods: A cross-sectional study was carried out in 130 newly diagnosed untreated patients with essential hypertension. Sixty-five healthy age- and sex-matched non-hypertensive individuals served as controls for comparison. Left ventricular mass and geometry were evaluated by transthoracic echocardiography. Blood samples were collected for assessing uric acid levels.Results: Hyperuricemia was present in 46.9% and 16.9% of cases and controls, respectively (P < 0.001). Mean serum uric acid was significantly higher among the patients with hypertension (384.79 ± 96.4 μmol/l) compared to controls (296.92 ± 89.8 μmol/l; P < 0.001). LVH was present in 55.4% of the cases and 10.8% of the controls (P < 0.001) and the commonest geometric pattern among the cases was concentric hypertrophy while the majority of the controls had normal left ventricular geometry. Among the hypertensive patients, LVH was commoner in the hypertensive patients with hyperuricemia compared to those with normal serum uric acid levels (70.5% versus 42.0%, P = 0.001) and the commonest geometry was concentric LVH. There was a significant linear relationship between mean uric acid levels and the left ventricular mass index (r = 0.346, P < 0.001). In regression analysis, uric acid was a significant independent predictor of LVH in women (β =0.406, P = 0.015) but not in men (β =0.161, P = 0.432).Conclusion: These results indicate that serum uric acid is associated with LVH in patients with hypertension especially women even at the time of diagnosis, thus may be a reliable marker of greater cardiovascular risk.