Relationship Between Hyperuricemia and Occurrence of Arterial Hypertension, Role of Uric Acid Index in Cardiovascular Risk Stratification (Literature Review)

Introduction. Hypertension is a global problem that significantly affects the health status, life expectancy and quality of life of patients. Despite the fact that the treatment and prevention of hypertension is a priority in many countries, the prevalence of this disease is increasing. This is of great concern, as hypertension is one of the leading causes of life-threatening complications. According to World Health Organization estimates, about 1,56 billion adults have hypertension, which is about 40.0 %, and the mortality associated with this disease reaches 13.0 % worldwide. Over the past decade, interest in cardiovascular diseases caused by elevated uric acid levels has increased significantly. Research findings confirm that hyperuricaemia is one of the main independent risk factors for the development of hypertension. This burden can be reduced through primary prevention, effective control and the elimination of risk factors. The aim of the study. To find out the relationship between hyperuricemia and arterial hypertension, to determine the role of the uric acid indicator in the stratification of the cardiovascular risk. Materials and methods. An analytical review of modern scientific sources, clinical recommendations, systematic reviews, meta-analyses, and clinical studies devoted to the role of hyperuricemia in the development of arterial hypertension and the identification of uric acid as one of the key factors in cardiovascular risk stratification was conducted. The sources for searching scientific publications were international electronic scientometric databases - PubMed, Scopus, Web of Science and Google Scholar. The time limit for publications was set from 2020 to 2026. Results. The prevalence of hyperuricemia in patients with hypertension ranges from 20.0 % to 40.0 %. For a long time, the question of determining the level of uric acid above which it becomes a cardiovascular risk factor remained open. It has been established that in groups of patients with high cardiovascular risk the uric acid level of 5.0 mg/dL (297.0 μmol/L) is a more clinically relevant threshold for predicting cardiovascular mortality than the traditional ≥7.0 mg/dL in men and ≥6.0 mg/dL in women. An increase in the level of uric acid in blood serum of 1 mg/dL is associated with an increase in the probability of developing hypertension by 13.0-15.0 % and an increase in the risk of left ventricle hypertrophy by 26.0 %. The combination of hyperuricemia with left ventricle hypertrophy is an independent and powerful predictor of death from cardiovascular diseases in both men and women. Conclusions. Hyperuricemia is one of the main independent risk factors for cardiovascular diseases, including arterial hypertension. The causal role of uric acid in the development of hypertension is realized through a close interaction between mechanisms that include genetic polymorphisms in urate anion transporters, neurohumoral and vascular pathways. The value of the uric acid indicator that predicts the risk of adverse events is within normal limits and below the threshold for increased risk of gout.