Poorly controlled hypertension is associated with elevated serum uric acid to HDL-cholesterol ratio: a cross-sectional cohort study.

Objectives: The diagnosis and follow-up of hypertension (HT) depend on the blood pressure measurements, which can be affected by several factors. In the present work, we aimed to explore the role of uric acid/HDL-cholesterol ratio (UHR) in HT and whether/or not it was associated with poor blood pressure control.

Methods: In this retrospective cross-sectional cohort study, all the participants treated for hypertension and then followed up in the internal medicine clinics of our institution were enrolled. Hypertensive patients were grouped as either poorly or well-controlled hypertension groups, according to the suggestions of Joint National Committee VIII criteria and healthy volunteers were enrolled as control group. UHR of the study groups was compared.

Results: Our study cohort consisted of 535 subjects; 258 in the well-controlled HT group, 186 in the poorly controlled HT group, and 91 in the control group. Median UHR levels of the poorly controlled HT group (13 (4-43) %) were significantly higher than well-controlled HT group 11 (4-22) %) and control group (8 (4-19) %) (p < 0.001). UHR was correlated with systolic (r = 0.33, p < 0.001) and diastolic (r = 0.28, p < 0.001) BP. UHR level greater than 11% has 70% sensitivity and 60% specificity in predicting poor BP control (AUC: 0.73, p < 0.001, 95%CI: 0.68-0.77). UHR was an independent risk factor for poor BP control in HT subjects and a unit elevation in UHR increased the risk of poorer BP control by 7.3 times (p < 0.001, 95%CI: 3.9-13.63).

Conclusion: Assessment of UHR may be useful in HT patients since elevated UHR levels could be associated with poor blood pressure control in this population.