Comparison of Serum Uric Acid-to-Creatinine Ratio in Patients with Controlled versus Resistant Hypertension

Abstract

Introduction: Resistant hypertension represents a significant clinical problem and carries a higher cardiovascular and renal risk. Uric acid and renal dysfunction have been proposed to be involved in hypertension, and the ratio of uric acid to creatinine (UA/Cr) could be a better biochemical indicator. Objective: To compare the serum UA/Cr ratio between patients with controlled and resistant hypertension and to see if there is any relationship between serum UA/Cr ratio and resistant hypertension. Methods: A comparative cross-sectional study was carried out at Shaikh Zayed Hospital, Lahore, involving 132 adults with hypertension, with 66 patients with controlled hypertension and 66 with resistant hypertension. Demographic, clinical, blood-pressure and biochemical information were obtained. Serum uric acid and creatinine were determined, and the ratio of UA/Cr was computed. The independent-samples t-test, Mann–Whitney U test, chi-square/Fisher's exact test, correlation analysis and binary logistic regression were used to analyze data. Results: The serum uric acid, creatinine, BMI, systolic and diastolic blood pressure, and hypertension duration were significantly higher in patients with resistant hypertension than in patients with controlled hypertension, whereas eGFR was lower. The mean UA/Cr ratio was significantly higher in resistant hypertension (6.72 ± 1.58 vs. 6.05 ± 1.46; p=0.011). The ratio positively correlated with systolic and diastolic blood pressure. Multivariable adjustment revealed that each UA/Cr increase was an independent risk factor for resistant hypertension (adjusted OR 1.34, 95% CI 1.04–1.73; p=0.023). Conclusions: The elevated serum UA/Cr ratio was independently associated with resistant hypertension and could be a simple biochemical indicator of more severe treatment resistance