Interaction of Inflammation, Hyperuricemia, and the Prevalence of Hypertension Among Adults Free of Metabolic Syndrome: NHANES 2009–2010

BACKGROUND Hyperuricemia and markers of inflammation are correlated with the risk for hypertension. Whether hyperuricemia has any impact on the association between C-reactive protein (CRP) and hypertension is not known. METHODS AND RESULTS We analyzed cross-sectional data from the National Health and Nutrition Examination Survey, 2009-2010, using ordinary least squares and logistic regression models. Those who met the criteria for metabolic syndrome, had self-reported gout, or were <20 years old were excluded. For each 1-SD increase in serum urate, the serum CRP concentration was 20% higher in unadjusted linear regression models and 13% higher in multivariable linear regression models, after accounting for the effects of age, sex, race, socioeconomic and educational strata, renal function, lipids, smoking, and body mass index. In multivariable models adjusting for the same covariates, hyperuricemia was associated with hypertension with an odds ratio of 2.21 (1.71 to 2.85). When analyzed separately, this was observed in men and women. In multivariable analyses of the overall sample, elevated CRP levels were not associated with hypertension. CONCLUSIONS Among adults free of metabolic syndrome, elevated uric acid, but not elevated CRP, is independently associated with prevalent hypertension.