Hyperuricemia and incident atrial fibrillation in a normotensive elderly population in Taiwan

S-Y Chuang; C-C Wu; P-F Hsu; R Chia-Yu Chen; W-L Liu; Y-Y Hsu; W-H Pan

doi:10.1016/j.numecd.2014.03.012

Hyperuricemia and incident atrial fibrillation in a normotensive elderly population in Taiwan

Nutr Metab Cardiovasc Dis. 2014 Sep;24(9):1020-6. doi: 10.1016/j.numecd.2014.03.012. Epub 2014 May 13.

Authors

S-Y Chuang¹, C-C Wu², P-F Hsu³, R Chia-Yu Chen¹, W-L Liu¹, Y-Y Hsu¹, W-H Pan⁴

Affiliations

¹ Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
² Department of Medicine, Branch of Hsinchu, National Taiwan University Hospital, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
³ School of Medicine, National Yang-Ming University, Taipei, Taiwan; Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medicine, National Yang-Ming University, Taiwan.
⁴ Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Institute of Epidemiology and Institute of Microbiology and Biochemistry, National Taiwan University, Taipei, Taiwan; School of Public Health, Department of medicine, National Yang Ming University, Taipei, Taiwan; Institute of BioMedical Sciences, Academia Sinica, Taipei, Taiwan. Electronic address: pan@ibms.sinica.edu.tw.

PMID: 24993310
DOI: 10.1016/j.numecd.2014.03.012

Abstract

Background and aim: Atrial fibrillation (AF) is an important cardiovascular disease in the elderly. The association between hyperuricemia and AF is unclear. Therefore, we aimed to investigate the prospective relationship between uric acid and development of AF in a nationally representative cohort of elderly people.

Methods and results: A total of 1485 elderly people (age ≥ 65 yrs) from the Elderly Nutrition and Health Survey in Taiwan (1999-2000) were without AF on "electrocardiography" at baseline. Incident AF events (International Classification of Diseases, Ninth Revision, Clinical Modification, ICD-9-CM: 427.31) were identified using data from the National Health Insurance Dataset. Hyperuricemia was defined as levels of uric acid >7.0 mg/dL in men and 6.0 mg/dL in women. A Cox proportional hazards model was used to evaluate the association between hyperuricemia and incident AF. The follow-up period was from 1999 to 2000 to 2008. During the follow-up period (median: 9.16 yrs), 90 AF events occurred (44 in men and 46 in women). Older age, elevated systolic blood pressure, being an ex-smoker, and high uric acid were positively associated with incident AF. Hyperuricemia was positively associated with incident AF in normotensive (age-adjusted hazard ratio (HR): 2.65 and 95% confidence intervals: 1.05-6.69), but not in (1.20:0.74-1.94) hypertensive individuals (systolic blood pressure ≥130 or diastolic blood pressure ≥85 or using hypertensive medicine). A significant association between hyperuricemia and AF (3.78; 1.24-11.59) remained after adjusting for other potential confounders among normotensive older persons.

Conclusion: Hyperuricemia is associated with the development of AF in elderly people with normal blood pressure.

Keywords: Atrial fibrillation; Elderly population; Hyperuricemia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Atrial Fibrillation / complications
Atrial Fibrillation / epidemiology*
Blood Pressure / physiology*
Electrocardiography
Female
Follow-Up Studies
Humans
Hypertension / drug therapy
Hypertension / epidemiology*
Hyperuricemia / complications
Hyperuricemia / epidemiology*
Incidence
Male
Proportional Hazards Models
Prospective Studies
Risk Factors
Surveys and Questionnaires
Taiwan / epidemiology
Uric Acid / blood

Substances

Uric Acid