July 6, 1999Annals of Internal Medicine
Serum Uric Acid and Risk for Cardiovascular Disease and Death: The Framingham Heart Study
Key result
During 117,376 person-years, elevated serum uric acid was not independently associated with coronary heart disease (617 events), cardiovascular death (429), or all-cause mortality.
Why the study?
Does elevated serum uric acid independently predict incident coronary heart disease, cardiovascular death, or all-cause mortality in a community-based cohort?
Population
6763 community-based participants from the Framingham Heart Study, mean age 47 years.
Comparison
Elevated serum uric acid level vs Lower serum uric acid quintiles
Design
Cohort
Follow-up
117,376 person-years
Authors
Discussion
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Implication
No independent link in large cohort cautions against uric acid for risk stratification; challenges prior observational associations and leaves causal role open.
Key Points
- To investigate the relationship between serum uric acid levels and the risk of coronary heart disease and mortality from cardiovascular disease and all causes.
- Community-based, prospective observational study with 6763 participants from the Framingham Heart Study.
- Measured serum uric acid levels at baseline (1971-1976) and tracked event rates over 117,376 person-years.
- Utilized a stepwise Cox model for analysis, adjusting for age and cardiovascular disease risk factors.
- 617 coronary heart disease events, 429 cardiovascular disease deaths, and 1460 deaths from all causes documented over the follow-up period.
- In women, higher serum uric acid levels were linked with increased risk for coronary heart disease (P=0.002) and cardiovascular disease mortality (P=0.009).
- After adjusting for cardiovascular risk factors, uric acid levels were not significantly predictive of outcomes, largely due to diuretic use as a covariate.
Study Design
Type
Observational (n=6,763)
Multicenter
No
Structured PICO
Does elevated serum uric acid independently predict incident coronary heart disease, cardiovascular death, or all-cause mortality in a community-based cohort?
P
Population
6,763 community-based participants (mean age 47 years) followed for 117,376 person-years to assess the association of serum uric acid with cardiovascular outcomes.
E
Exposure
Elevated serum uric acid level (evaluated by sex-specific quintiles)
C
Comparator
Lower serum uric acid quintiles
O
Outcome
Incident coronary heart disease, death from cardiovascular disease, and death from all causeshard clinical
Cite This Study
Culleton et al. (1999) reported an observational. Serum uric acid level vs. Lower serum uric acid levels was evaluated on Incident coronary heart disease, death from cardiovascular disease, and death from all causes. During 117,376 person-years, elevated serum uric acid was not independently associated with coronary heart disease (617 events), cardiovascular death (429), or all-cause mortality.