Approved Research

The Relationship Between Normal Blood Pressure Values, Serum Uric Acid and Cardiovascular and Metabolic Phenotypes.

Lay summary

Diseases of the brain, heart and kidneys remain the leading cause of death worldwide, despite the improvement in drug-development and prevention strategies. This might be related to the difficulties in identifying the patient phenotype at higher risk of cardiometabolic damage, which should be treated earlier and more aggressively.

Hypertension is one of the most acknowledged cardiovascular risk factors. Some recent observations highlighted an increased risk of hypertension-related mortality beginning at blood pressure levels far lower than the classical cut-offs for hypertension. Another study pointed out that the quasi-linear relationship of blood pressure and atherosclerotic disease begin at systolic blood pressure levels as low as 90 mmHg.

Uric acid has attracted substantial attention over the last decade. Several studies have suggested that high levels of uric acid might be associated with the risk of cardiac, brain and kidney diseases, independently from other common cardiovascular risk factors, including the most acknowledged cholesterol, smoking, blood pressure and diabetes. These support the importance of uric acid when assessing the individual cardiovascular risk.

However, the levels of uric acid related to an increased risk of target organ damage remain unknown. Also, it remains unknown how between uric acid and blood pressure interact with each other and lead to the hypertension-mediated organ damage.

In this project, we aim to define the mortality and hypertension-mediated organ damage risk related to values of blood pressure and serum uric acid currently acknowledged as normal. To do so, we will first analyze the clinical data of the patients and then their genetic background. This integrated approach will give strength to our results.

We propose to use the UK Biobank study to address these research questions, relating baseline uric acid levels and blood pressure values with the mortality and organ damage data available in this large dataset. A precise identification and definition of how and when blood pressure and serum acid uric begin to exert their noxious effect in terms of cardiovascular mortality and organ damage will support implementation of current clinical guidelines. Due to the multiple statistical analyses that will be necessary for this study and the large amount of data that has to be processed, we can predict a total duration of the project of two years.