[Is there an association of uric acid level with preclinical target organ damage in moderate- and high-risk hypertensive patients?].

AIM: To assess an association of uric acid level with preclinical target organ damage in patients with hypertensive disease (HD). SUBJECTS AND METHODS: The trial enrolled 100 patients (63 men and 37 women) with Stage I-II HD at moderate and high risk for cardiovascular events (CVEs). The mean age of the patients was 44.9 +/- 1.3 years. Their medical history showed that the duration of hypertension averaged 4.4 +/- 0.3 years. The average daily level of systolic blood pressure (BP) was 138.1 +/- 1.4 mm Hg and that of diastolic BP was 84.3 +/- 1.1 mm Hg. RESULTS: The entire patient group showed a positive correlation between C-reactive protein (CRP) and serum uric acid (SUA) (r = 0.27; p < 0.01), suggesting that the nonspecific inflammatory processes were associated with uric acid levels in patients with HD. An intragroup analysis also revealed a relationship between CRP and SUA levels in the hypertensive patients at high risk for CVEs (r = 0.43; p = 0.01); this relationship was not found in those at their low risk. The hypertensive patients were ascertained to have elevated CRP levels and microalbuminuria, hyperuricosuria, and glomerular hyperfiltration when they had a SUA level >319 micromol/l. CONCLUSION: It can be assumed that the SUA level >319 micromol/l triggers the activation of nonspecific inflammatory processes, which in turn affects renal microvessels.

[Obstructive sleep apnea and a cardiovascular risk in patients with arterial hypertension].

OBJECTIVE: To study an independent role of the obstructive sleep apnea syndrome (OSAS) in patients with arterial hypertension (AH) according to the data of a retrospective observation. SUBJECTS AND METHODS: all patients underwent polysomnographic test (EMBLA Flaga, Iceland) and the frequency of unfavorable events (stroke, myocardial infarction, chronic heart failure, atrial fibrillation, intermittent claudication, or death) was determined during the case-control observational longitudinal retrospective study. The diagnosis of OSAS was made when the apnea-hypopnea index (AHI) of more than 15 events per hour of sleep; the patients with an AHI of less than 15 formed a control group. RESULTS: Among 120 enrolled patients, 64 (53%) had OSAS. In the patients with OSAS, the baseline AHI was 50.9 +/- 23 events per hour whereas in the control group it was 8.9 +/- 5.2 per hours. Both groups were comparable in age, height, weight, body mass index, snore duration, drowsiness, and respiratory standstill during sleep, blood pressure, total cholesterol, and creatine. While analyzing OSAS, there was no change in the risk for a combined end point (all-cause death, stroke, myocardial infarction, chronic heart failure, atrial fibrillation, or intermittent claudication). Our study was retrospective, the patients were few and AH is itself an important cardiovascular risk factor which should be borne in interpreting the results of our study. We consider that the study of the independent role of OSAS should be continued within a well-designed prospective observation.