Sex- and country-specific associations of hyperuricemia and inflammation with vascular aging across populations with diverse cardiovascular risks

Introduction The importance of measuring vascular age has been emphasized in numerous studies, highlighting its critical role in precision medicine. This cross-sectional heterogeneity exploration study examined sex- and country-specific association of serum uric acid (SUA) and inflammation, measured as high sensitivity C-reactive protein (hs-CRP), and vascular aging across populations with diverse cardiovascular risks. Methods This work analyzed data from three cohorts: 4,802 individuals from Sweden (SCAPIS – The Swedish CArdioPulmonary bioImage Study, n = 3,255), Lithuania (LitHiR – The Lithuanian High Cardiovascular Risk Prevention Program, n = 708), and Spain (The Sagunto Cohort, n = 838). Standard clinical and laboratory variables were used; aortic stiffness measured via carotid-femoral pulse wave velocity (cfPWV) (Sphygmocor), employing the foot-to-foot method in the right carotid and femoral arteries. In addition. Sex disaggregated analysis was performed. Results The study involved individuals with a mean age of 56 (±8) years, 53% women, 48% never smokers, 41% with hypertension, and 20% with diabetes. In adjusted for cardiometabolic factors linear models, hs-CRP was associated with cfPWV only in Swedish men ( p = 0.007), while SUA was associated with cfPWV in Swedish men ( p = 0.001) and Lithuanian women ( p = 0.029). In logistic regression, SUA predicted higher odds of cfPWV >10 m/s in Swedish men (OR 1.003, p = 0.041), and in Lithuanian women this prediction was of borderline significance (OR 1.004, p = 0.065). In Spanish women, the association with SUA was negative and of borderline significance (OR 0.995, p = 0.067). hs-CRP was not associated with cfPWV >10 m/s in adjusted models. Conclusion This cross-sectional exploratory study provides evidence that SUA and hs-CRP are associated with vascular aging, although their predictive value should be interpreted in a sex- and country-specific context.