Prevalence and risk factors for hyperuricemia among patients with hypertension at Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Objective: Uric acid, a mediator of high blood pressure, is an inexpensive easyto-obtain indicator of cardiovascular risk (stroke, myocardial infarction and renal disease). This study was conducted to determine the prevalence and risk factors for hyperuricemia among patients with hypertension in western Kenya.

Methods: This cross-sectional study conducted at the Moi Teaching and Referral Hospital in western Kenya, enrolled randomly selected adults (≥ 18 years) with hypertension, attending medical outpatients’ clinic. Clinical (age, gender, stroke history, Body Mass Index, antihypertensive drugs and duration of illness) and laboratory (fasting lipid profile, blood sugar, uric acid and serum creatinine) data were collected. Data were keyed into Microsoft excel database and analyzed using STATA© version 13. Descriptive statistics were summarized using means, frequencies and proportions. Risk factors for hyperuricemia were analysed using two-sample t-tests, twosample Wilcoxon rank sum tests and Pearson’s Chi Square tests.

Results: Of the 275 participants enrolled, 182 (66%) were female, mean age 54 (sd 12.5) years, mean Body Mass Index 28.9 (sd 4.9) and median duration of illness 6 months. Overall prevalence of hyperuricemia was 44%; with 37.6% and 47.3% in males and females respectively.Factors associated with hyperuricemia included high Body Mass Index (p 0.036), low Glomerular Filtration Rate (P<0.0001) and dyslipidemia (p<0.0001).

Conclusion: There is a high prevalence of hyperuricemia among patients with hypertension in western Kenya. Risk factors associated with hyperuricemia include high Body Mass Index, dyslipidemia and low glomerular filtration rate. The use of losartan and calcium channel blockers is recommended in patients with hyperuricemia and  subsequent longitudinal studies to be done to determine utility of uric acid monitoring in blood pressure control.

Keywords: Hypertension, Hyperuricemic Lipid Profile, Body Mass Index, Estimated Glomelular Filtration Rate (eGFR)