Letter to the Editor

Hyperuricemia as a risk factor for cardiovascular disease Expert Review of Cardiovascular Therapy Downloaded from informahealthcare.com by Karolinska Institutet University Library on 01/28/15 For personal use only.

Expert Rev. Cardiovasc. Ther. 13(1), 19–20 (2015)

Niki Katsiki 2nd Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece

Michael Doumas 2nd Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece and Department of Veterans Affairs and George Washington University, Washington DC, USA

Vasilios G Athyros Author for correspondence: 2nd Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece Tel.: +30 231 089 2606 Fax: +30 231 083 5955 [email protected]

Asterios Karagiannis 2nd Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece

informahealthcare.com

Response to: Borghi C, Verardi FM, Pareo I, Bentivenga C, Cicero AF. Hyperuricemia and cardiovascular disease risk. Expert Rev Cardiovasc Ther 2014;12(10):1219-25.

We read the review by Borghi et al. [1] with interest. The authors discuss possible causes and treatments of hyperuricemia as well as the links between elevated serum uric acid (SUA) levels and cardiovascular (CV) risk factors. Borghi et al. [1] mention that loop diuretics, thiazides and aspirin may increase SUA levels, whereas losartan may decrease them. However, there are also other drugs that have been reported to reduce SUA levels including calcium channel blockers (i.e., amlodipine), angiotensin-converting enzyme inhibitors (i.e., captopril, enalapril and ramipril), lipid lowering (i.e., atorvastatin, simvastatin, ezetimibe and fenofibrate), weight reducing (e.g., orlistat) and hypoglycemic agents (i.e., metformin) [2], although data are limited. Dapagliflozin, a new antidiabetic drug that inhibits sodium glucose transporter-2 in the kidneys, was also shown to lower SUA levels [3]. Furthermore, we have previously found that multifactorial treatment, including a statin, significantly improved renal function and decreased SUA concentrations, even in patients with stage 3 chronic kidney disease [4,5]. Such drug-induced SUA lowering effects have been reported to contribute to CV risk reduction in the Losartan Intervention For Endpoint reduction in hypertension [6], as Borghi et al. [1] state. We have shown

10.1586/14779072.2015.987129

similar results in the Greek atorvastatin and coronary-heart disease Evaluation study [7]. Borghi et al. [1] mention the associations between hyperuricemia and hypertension, diabetes, obesity, dyslipidemia and the metabolic syndrome. Elevated SUA levels have also been linked to both micro- and macrovascular diabetic complications [8]. Furthermore, hyperuricemia was related to other CV risk predictors such as non-alcoholic fatty liver disease [9] and stage 3 chronic kidney disease [10]. Finally, Borghi et al. [1] discuss the association between elevated SUA levels and stroke. In this context, we have previously found that hyperuricemia was related to an increased in-hospital mortality after acute stroke [11]. Financial & competing interests disclosure

N Katsiki has given talks and attended conferences sponsored by Novartis, Pfizer, MSD and AstraZeneca. A Karagiannis has given talks and attended conferences sponsored by Menarini, AstraZeneca, Novartis and Pfizer. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Ó 2015 Informa UK Ltd

ISSN 1477-9072

19

Letter to the Editor

Katsiki, Doumas, Athyros & Karagiannis

References 1.

Expert Review of Cardiovascular Therapy Downloaded from informahealthcare.com by Karolinska Institutet University Library on 01/28/15 For personal use only.

2.

Borghi C, Verardi FM, Pareo I, et al. Hyperuricemia andcardiovascular disease risk. Expert Rev Cardiovasc Ther 2014; 12(10):1219-25 Katsiki N, Karagiannis A, Athyros VG, Mikhailidis DP. Hyperuricaemia: morethan just a cause of gout? J Cardiovasc Med (Hagerstown) 2013;14:397-402

3.

Thomas MC. Renal effects of dapagliflozin in patients with type 2 diabetes. Ther Adv Endocrinol Metab 2014;5:53-61

4.

Athyros VG, Hatzitolios AI, Karagiannis A, et al. improving the implementation of current guidelines for the management of major coronary heart disease risk factors by multifactorial intervention. The IMPERATIVE renal analysis. Arch Med Sci 2011;7:984-92

20

5.

6.

7.

Athyros VG, Karagiannis A, Ganotakis ES, et al. Association between the changes in renal function and serum uric acid levels during multifactorial intervention and clinical outcome in patients with metabolic syndrome. A post hoc analysis of the ATTEMPT study. Curr Med Res Opin 2011;27:1659-68 Høieggen A, Alderman MH, Kjeldsen SE, et al. The impact of serum uric acid on cardiovascular outcomes in the LIFE study. Kidney Int 2004;65:1041-9 Athyros VG, Elisaf M, Papageorgiou AA, et al. GREACE Study Collaborative Group: effect of statins versus untreated dyslipidemia on serum uric acid levels in patients with coronary heart disease. A subgroup analysis of the GREek Atorvastatin and Coronary-heart-disease Evaluation (GREACE) study. Am J Kidney Dis 2004;43:589-99

8.

Katsiki N, Papanas N, Fonseca VA, et al. Uric acid and diabetes: is there a link? Curr Pharm Des 2013;19:4930-7

9.

Katsiki N, Athyros VG, Karagiannis A, Mikhailidis DP. Hyperuricaemia andnon-alcoholic fatty liver disease (NAFLD): a relationship with implications for vascular risk? Curr Vasc Pharmacol 2011;9:698-705

10.

Richette P, Perez-Ruiz F, Doherty M, et al. Improving cardiovascular and renal outcomes in gout: what should we target? Nat Rev Rheumatol 2014;10(11):654-61

11.

Karagiannis A, Mikhailidis DP, Tziomalos K, et al. Serum uric acid as an independent predictor of early death after acute stroke. Circ J 2007;71:1120-7

Expert Rev. Cardiovasc. Ther. 13(1), (2015)

Hyperuricemia as a risk factor for cardiovascular disease.

Hyperuricemia as a risk factor for cardiovascular disease. - PDF Download Free
125KB Sizes 3 Downloads 6 Views