Clinical profile of patients with hypertension and gout in a cardiology hospital

Objective : To study the clinical features of patients with arterial hypertension (AH) and gout with an assessment of the ongoing antihypertensive therapy (AHT) hospitalized in a cardiology hospital. Materials and methods : The study included 40 patients over 18 years old who were hospitalized at the Chazov EI National Medical Research Center for Cardiology with diagnoses of AH and gout. The average age of the patients was 59.6±12.8 years, and 80% were men. The assessment of sex, age, body mass index (BMI), medical records, comorbidities and harmful habits was conducted. Laboratory tests measured uric acid (UA), glucose, and lipid profile parameters. Instrumental methods included echocardiography (EchoCG) and 24-hour blood pressure monitoring (ABPM). Depending on whether the target blood pressure (BP) of less than 140/90 mmHg, patients were divided into groups with controlled and uncontrolled hypertension. Result : Uncontrolled AH was found in 18 (45%) patients, while controlled AH was seen in 22 (55%). The average office systolic blood pressure (SBP) in the uncontrolled group was 154,0±16,4 mmHg, and in the controlled group — 121,0±7,2 mmHg (p<0.001*). Elevated pulse pressure was predominant in over 70% of patients not reaching target BP levels, compared to 17% in the BP control group (p<0.001*). When evaluating the 24-hour BP profile, non-dippers (61.1%) and night-pickers (16.7%) were significantly more common in the first group, compared to the group that reached target BP levels (13.6% and 4.5%, p<0.001*). Correlations were found between office SBP and uric acid (UA) (rxy=0.386, p=0.029), low-density lipoprotein (LDL) levels (rxy=0.382, p=0.024), triglycerides (rxy=0.454, p=0.006), and total cholesterol (rxy=0.505, p=0.002). Regression analysis showed a dependence of office SBP on the level of UA: with an increase in UA by 50 μmol/L, an increase in office SBP by 4 mm Hg an should be expected. Conclusions : In patients with hypertension and gout, an increased level of office SBP correlates with hyperuricemia and high blood lipids, while there is a linear relationship between UA and office SBP. In patients with hypertension and gout, in addition to off-target levels of UA and lipid metabolism indicators, there is an insufficient decrease in BP at night, especially in the group with uncontrolled flow of hypertension, which requires routine ABPM to assess the daily BP profile.