Substantial amount of epidemiologic studies showed that hyperuricemia is highly associated with cardiovascular disorders, chronic renal disease, and diabetes mellitus development risk. This fact shows necessity of increased focus on uric acid level in serum not only in relation to rheumatic disorders but also in relation to cardiovascular and renal risk. European Society of Cardiology and Russian Arterial Hypertension Society experts included tests on uric acid level serum concentration in routine tests for hypertensive patients. Important steps in increase of hyperuricemia control in clinical practice are increase of awareness as a risk factor of cardiovascular disorders, development of risk management algorithm for patients with hyperuricemia and high cardiovascular risk, and increase of treatment adherence. Decrease of uric acid level in serum achieved after treatment with urate decreasing therapy mostly with xanthine oxidase inhibitor is associated with improvement of blood pressure control and decrease of cardiovascular adverse events frequency.
Значительное количество эпидемиологических исследований продемонстрировало, что гиперурикемия в высокой степени связана с риском развития сердечно-сосудистых заболеваний, хронической болезни почек и сахарного диабета, в связи с чем необходимо повышенное внимание к мониторингу уровня мочевой кислоты в сыворотке крови у пациентов не только с точки зрения ревматических болезней, но также и в отношении снижения сердечно-сосудистого и почечного риска. Эксперты Европейского общества кардиологов и Российского медицинского общества по артериальной гипертонии включили в рутинные тесты измерение концентрации мочевой кислоты в сыворотке крови у больных артериальной гипертонией. Важным шагом на пути улучшения контроля гиперурикемии в клинической практике являются повышение осведомленности о гиперурикемии как о факторе риска сердечно-сосудистых заболеваний, разработка алгоритма ведения больных с гиперурикемией и высоким сердечно-сосудистым риском, повышение приверженности рекомендациям. Снижение уровня мочевой кислоты в сыворотке крови, достигнутое посредством лечения пациентов уратснижающими препаратами, главным образом ингибитором ксантиноксидазы, связано с улучшением контроля артериального давления и уменьшением частоты нежелательных сердечно-сосудистых событий.
Aim. To study the association of high-sensitivity C-reactive protein (hsCRP) level with socio-demographic, behavioral and traditional risk factors in different regions of the Russian Federation (RF). Material and methods. Data of the multicenter epidemiological study of cardiovascular disease in different regions of the Russian Federation (ESSE-RF) were used. Representative sample of the unorganized male and female population aged 25-64 from 6 regions of the Russian Federation was drown. 3407 men and 6354 women (n=9761) were included into the study. Standard questionnaire was applied in all subjects. Gender, age, level of education, place of residence and region of residence, traditional risk factors and diseases were analyzed. HsCRP level (level ≥3.0 mg/l was defined as elevated one) was evaluated to detect of indolent inflammation. Results. HsCRP levels in women was significantly higher compared to males (p<0.005). The average prevalence of elevated hsCRP in the regions was 24.2%, for men - 21.4%, and for women - 25.7% (p<0.005). Significant age-related dynamics of hsCRP (p<0.0001) was found. The average level of hsCRP was significantly lower (p<0.0001) in a cohort of persons with higher education against these with lower level of education. Level of hsCRP as well as prevalence of elevated hsCRP level were higher in villagers than this in the urban population (p<0.05). Prevalence of elevated hsCRP in patients with traditional risk factors after adjustment for sex, age, and region of residence showed that the elevated hsCRP was mostly associated with metabolic factors and diseases that were characterized by systemic inflammation. Conclusion. Elevated level of hsCRP (≥3.0 mg/l) was significantly associated with female gender, with an older, less educated, and smoking population of Russians. After the multivariate adjustment there remained significant associations (p<0.0001) of elevated hsCRP level with obesity, including abdominal obesity, hyperglycemia and hypertriglyceridemia, low levels of low density cholesterol, rheumatoid arthritis, chronic bronchitis and Parkinson's disease.