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The relationship of blood pressure with uric acid and bilirubin in young lean and overweight/obese men and women: the African-PREDICT study

Journal of Human Hypertension volume 34, pages 648–656 (2020)Cite this article

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Abstract

Mounting evidence supports the central role of oxidative stress and inflammation in obesity and the development of hypertension. However, most studies focusing on the non-enzymatic antioxidants, such as uric acid and bilirubin, and their relationship with obesity and hypertension were done in older populations with overt cardiovascular disease. The aim of this study was therefore to compare measures of cardiovascular function (blood pressure and arterial stiffness) and non-enzymatic antioxidants (uric acid and bilirubin) between young healthy lean and overweight/obese men and women and to investigate the link between these variables. We grouped 967 men and women (aged 20–30 years) according to body mass index (BMI) categories (lean BMI < 25 kg/m2; overweight/obese BMI ≥ 25 kg/m2). Cardiovascular measurements included 24 h blood pressure and carotid-femoral pulse wave velocity. Serum samples were used to analyse uric acid and bilirubin. Women and men with a BMI ≥ 25 kg/m2 displayed higher 24 h blood pressure (P < 0.001) and uric acid (P ≤ 0.014) than their lean counterparts; lean women showed higher bilirubin (P < 0.001). In multi-variable adjusted regression analyses we found that 24 h systolic blood pressure was independently associated with uric acid (R2 = 0.10; β = 0.19; P = 0.017) only in overweight/obese women. In lean women a negative association of 24 h systolic blood pressure with bilirubin (R2 = 0.03; β = −0.14; P = 0.018) was found. No associations were found in men. In conclusion, we found adverse associations between blood pressure and uric acid in young healthy women with increased adiposity, but not in lean women or men.

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Acknowledgements

The authors are grateful towards all individuals participating voluntarily in the study. The dedication of the support and research staff as well as students at the Hypertension Research and Training Clinic at the North-West University are also duly acknowledged. The research funded in this manuscript is part of an ongoing research project financially supported by the South African Medical Research Council (SAMRC) with funds from National Treasury under its Economic Competitiveness and Support Package; the South African Research Chairs Initiative of the Department of Science and Technology and National Research Foundation (NRF) of South Africa (GUN 86895); the SAMRC with funds received from the South African National Department of Health, GlaxoSmithKline R&D (Africa Non-Communicable Disease Open Lab grant), the UK Medical Research Council and with funds from the UK Government’s Newton Fund; as well as corporate social investment grants from Pfizer (South Africa), Boehringer-Ingelheim (South Africa), Novartis (South Africa), the Medi Clinic Hospital Group (South Africa) and in kind contributions of Roche Diagnostics (South Africa). Any opinion, findings, and conclusions or recommendations expressed in this material are those of the authors, and therefore, the NRF does not accept any liability in this regard.

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Authors and Affiliations

  1. Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa

    Wessel L. Du Toit, Aletta E. Schutte & Catharina M. C. Mels

  2. MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa

    Aletta E. Schutte & Catharina M. C. Mels

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  1. Wessel L. Du Toit
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Correspondence to Catharina M. C. Mels.

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Supplementary information

41371_2019_287_MOESM1_ESM.docx

Table S1. Interactions of sex and body mass index on the relationships between 24h systolic blood pressure and pulse wave velocity with uric acid and bilirubin

Table S2. Characteristics of lean and overweight obese men

41371_2019_287_MOESM3_ESM.docx

able S3. Partial correlation analyses of 24h systolic blood pressure and pulse wave velocity with uric acid and bilirubin in men (adjusted for ethnicity and age)

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Du Toit, W.L., Schutte, A.E. & Mels, C.M.C. The relationship of blood pressure with uric acid and bilirubin in young lean and overweight/obese men and women: the African-PREDICT study. J Hum Hypertens 34, 648–656 (2020). https://doi.org/10.1038/s41371-019-0287-7

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