Is Uric Acid Level an Independent Risk Factor for Cardiovascular Disease in a Newfoundland Population?
In 1923, a Swedish scientist by the name of Kylin identified a syndrome characterized by high blood glucose, hypertension, and elevated blood uric acid levels. Today, this condition is known as the metabolic syndrome (MetSyn) which is described as a clustering of risk factors, such as abdominal obesity, increased blood glucose, abnormal blood lipids and hypertension, and leads to a high risk of cardiovascular disease (CVD) and type-2 diabetes. The relation between uric acid and CVD has been observed in many epidemiological studies. There are also studies which have shown an association between elevated uric acid, or hyperuricemia, and MetSyn. None of the modern definitions of MetSyn, however, include hyperuricemia as a possible component of this syndrome.
Between 1991 and 1993, a random and representative sample of 791 individuals from three rural communities in Newfoundland, Carbonear, St. Anthony and Twillingate, participated in a community CVD prevention trial. A unique set of body measurements, laboratory data and medical history information was collected during this original trial, including uric acid and all the components needed to diagnose MetSyn. A 15-year follow-up study of this previously established cohort is in progress to find out how many clinical events have occurred since 1990 and to conduct an up-to-date health examination.
One of the objectives of this follow-up study is to evaluate whether hyperuricemia is independently associated with MetSyn. Preliminary analysis of the baseline data suggests a strong relationship between uric acid and MetSyn. Another aim of this research is to assess if adding uric acid levels to the definition of MetSyn will improve the prediction of CVD risk in a Newfoundland population. It is hypothesized that including uric acid measurement together with MetSyn will identify a greater number of individuals at high risk of CVD.
The rates of CVD mortality in Newfoundland and Labrador are among the highest in Canada, therefore, the need to prevent CVD which may in turn reduce the burden of disease in this Province is critical. Preventive strategies, however, can only be successful if targeted at individuals who are in fact at increased health risk. This study has the potential of generating important new knowledge on whether blood uric acid is independently linked to MetSyn and if adding uric acid measurement to the diagnosis of MetSyn will improve the prediction of future CVD risk. This information is currently limited and could contribute to the development of simplified yet effective CVD risk assessment tools.