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Serum Uric Acid Concentration as a Risk Factor for Cardiovascular Mortality: A Longterm Cohort Study of Atomic Bomb Survivors
MASAYUKI HAKODA, NAOMI MASUNARI, MICHIKO YAMADA, SAEKO FUJIWARA, GEN SUZUKI, KAZUNORI KODAMA, and FUMIYOSHI KASAGI
ABSTRACT.
Methods. Serum uric acid level measured from 1966 through 1970 in 10,615 Japanese individuals from a cohort of atomic bomb survivors was analyzed for association with subsequent cardiovascular and all-cause mortality until 1999 using the Cox proportional hazard model. Results. During an average followup of 24.9 years, 5225 deaths occurred, of which 1984 were ascribed to cardiovascular disease. In men, after adjustment for age, elevated serum uric acid level was associated with both cardiovascular and all-cause mortality. After additional adjustment for potential cardiovascular disease risk factors including body mass index, smoking status, alcohol consumption, systolic blood pressure, cholesterol level, and histories of hypertension, diabetes and cardiovascular disease, elevated serum uric acid level in men was associated with all-cause mortality but not with cardiovascular mortality. In women, even after these adjustments, elevated serum uric acid level was significantly associated with cardiovascular and all-cause mortality. Conclusion. Increased serum uric acid level is a significant and independent risk factor for cardiovascular mortality in women and for all-cause mortality in both men and women. (J Rheumatol 2005;32:906-12) Key Indexing Terms:
URIC ACID
From the Department of Clinical Studies and the Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan. The Radiation Effects Research Foundation is a private, nonprofit foundation funded equally by the Japanese Ministry of Health, Labor and Welfare and the US Department of Energy through the National Academy of Sciences. M. Hakoda, MD, PhD, Chief, Division of Clinical Laboratories; N. Masunari, BSc, Pharmacist; M. Yamada, MD, PhD, Chief, Division of Health Examinations; S. Fujiwara, MD, PhD, Chief, Department of Clinical Studies; F. Kasagi, PhD, Assistant Chief, Department of Epidemiology; G. Suzuki, MD, PhD, Chief Scientist, Radiation Effects Research Foundation; K. Kodama, MD, PhD, Chief Scientist, Radiation Effects Research Foundation. Address reprint requests to Dr. M. Hakoda, Department of Clinical Studies, Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan. E-mail: hakoda@rerf.or.jp Accepted for publication December 16, 2004. |