Relation of BMI and waist circumference with the risk of new-onset hyperuricemia in hypertensive patients

Background: We aimed to evaluate the relationship of body mass index (BMI) and waist circumference (WC) with the risk of new-onset hyperuricemia, and examine possible effect modifies in general hypertensive patients.

Methods: A total of 10 611 hypertensive patients with normal uric acid (UA) concentrations (<357 μmol/l) at baseline were included from the UA sub-study of the China Stroke Primary Prevention Trial. The primary outcome was new-onset hyperuricemia, defined as a UA concentration ≥417 μmol/l in men or ≥357 μmol/l in women at the exit visit.

Results: During a median follow-up duration of 4.4 years, 1663 (15.7%) participants developed new-onset hyperuricemia. When analyzed separately, increased BMI (≥25 kg/m2, quartile 3-4; OR, 1.46; 95% CI: 1.29-1.65), or increased WC (≥85 cm for females, quartile 3-4; OR, 1.24; 95% CI: 1.08-1.42; and ≥84 cm for males, quartile 3-4; OR, 1.30; 95% CI: 1.01-1.67) were each significantly associated with higher risk of new-onset hyperuricemia. When WC was forced into the model with BMI simultaneously, its significant association with new-onset hyperuricemia disappeared in females (<85 vs. ≥85 cm; OR, 0.96, 95% CI: 0.81-1.13) or males (≥84 vs. <84 cm; OR, 1.13; 95% CI: 0.84-1.52); however, BMI was still significantly related with new-onset hyperuricemia (≥25 vs. <25 kg/m2; OR, 1.48; 95% CI: 1.27-1.73). Moreover, the positive BMI & new-onset hyperuricemia association was more pronounced in participants with higher time-averaged on-treatment systolic blood pressure (median: <138.3 vs. ≥138.3 mmHg; P-interaction = 0.041).

Conclusions: Higher BMI, but not WC, is significantly and independently associated with an increased risk of new-onset hyperuricemia among hypertensive patients.