Increased Burden of Patients With Hyperuricemia in the Era of New Risk Scale Score-2 Implementation

Objective: Hyperuricemia is an independent, modifiable risk factor for the development and progression of cardiovascular disease. According to recent expert consensus (Borghi C., 2021), a target uric acid (UA) level that should be achieved with urate-lowering therapy was defined based on the cardiovascular risk: <360 μmol/L in case of low and moderate risk and <300 μmol/L in case of high and very high risk. We aimed to assess the prevalence of elevated uric acid levels for different cardiovascular risk groups and scales in the Russian population-based sample. Design and method: A random population sample of 4,800 participants from three regions (age 25-64 years) was examined as a part of the Russian epidemiologic study ESSE-RF. All patients signed informed consent and completed a questionnaire about behavioral risk factors, comorbidities and therapy, standard anthropometry, laboratory examination (creatinine, glucose, lipids, uric acid), anthropometry. Blood pressure (BP) was measured on the right arm in the sitting position after 5-minute rest by automatic tonometer OMRON (Japan). SCORE (European guidelines on dyslipidemia 2019) and SCORE2 (European guidelines on cardiovascular prevention 2021) were used to assess cardiovascular risk. Participants under 40 years of age were excluded from the analysis (n=1551). Statistical analysis was performed using IBM SPSS Statistics 23. Results: A total of 3216 individuals with complete data were included in the analysis - 1175 (36,5%) males and 2041 (63,5%) females (Table 1). Conclusions: Implementation of a new risk approach - SCORE-2 results in a 3-fold increase in a number of patients with high and very high risk. As a result, population prevalence of elevated uric acid level raises by 32%. Prescription of urate-lowering therapy as a risk-decreasing strategy to 44,4% of population might lead to polypharmacy and needs more evidence (Agreement No. 075-15-2022-301).