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Background <p>There is inconsistency in historical evidence on the relationship between uric acid (UA) level and cardiovascular disease (CVD) risk. This study aimed to investigate the association between UA and risk of incident CVD in healthy older adults who were free of CVD initially.</p> Methods <p>10,794 participants aged ≥ 70&#xa0;years from the ASPREE trial were included. Primary outcomes were incident CVD and incident major adverse cardiovascular events (MACE). Secondary outcomes included myocardial infarction (MI), stroke, and hospitalisation for heart failure (HHF). Multivariable Cox-proportional-hazard models analysed the association between baseline UA levels and study outcomes. Restricted cubic splines identified any non-linear associations, a subgroup analysis explored potential effect modifiers.</p> Results <p>Over a median of 8.4&#xa0;years, 1078 CVD and 826 MACE events occurred. In full-adjusted model, higher UA was significantly associated with an increased risk of incident CVD [HR 1.26 (95% CI: 1.03–1.56), <i>p</i> = 0.04] and MACE [1.32, 1.04–1.69, <i>p</i> = 0.05], and MI [1.50, 1.04–2.16, <i>p</i> = 0.08]. Restricted cubic splines showed a monotonic association between UA and incident CVD, MACE and MI. UA was not significantly associated with stroke and HHF. Subgroup analyses showed no significance between UA and sex, obesity, diabetes, or high blood pressure for major CVD outcomes (all p for interaction &gt; 0.05).</p> Conclusions <p>Higher UA levels were associated with significantly increased risk of incident CVD, MACE, MI events in healthy older adults. This highlighted UA as a potential modifiable risk factor, warranting future studies on UA-lowering medication in CVD primary prevention.</p>

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The association between uric acid and incident cardiovascular events amongst healthy, community-dwelling older adults

  • 期刊论文

  • 发表日期：

    2025年11月15日

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  • Amily Lo,
  • Amanda J. Rickard,
  • Nazmul Karim,
  • Cammie Tran,
  • Joanne Ryan,
  • John J. McNeil,
  • Swarna Vishwanath,
  • Zhen Zhou

摘要

Background

There is inconsistency in historical evidence on the relationship between uric acid (UA) level and cardiovascular disease (CVD) risk. This study aimed to investigate the association between UA and risk of incident CVD in healthy older adults who were free of CVD initially.

Methods

10,794 participants aged ≥ 70 years from the ASPREE trial were included. Primary outcomes were incident CVD and incident major adverse cardiovascular events (MACE). Secondary outcomes included myocardial infarction (MI), stroke, and hospitalisation for heart failure (HHF). Multivariable Cox-proportional-hazard models analysed the association between baseline UA levels and study outcomes. Restricted cubic splines identified any non-linear associations, a subgroup analysis explored potential effect modifiers.

Results

Over a median of 8.4 years, 1078 CVD and 826 MACE events occurred. In full-adjusted model, higher UA was significantly associated with an increased risk of incident CVD [HR 1.26 (95% CI: 1.03–1.56), p = 0.04] and MACE [1.32, 1.04–1.69, p = 0.05], and MI [1.50, 1.04–2.16, p = 0.08]. Restricted cubic splines showed a monotonic association between UA and incident CVD, MACE and MI. UA was not significantly associated with stroke and HHF. Subgroup analyses showed no significance between UA and sex, obesity, diabetes, or high blood pressure for major CVD outcomes (all p for interaction > 0.05).

Conclusions

Higher UA levels were associated with significantly increased risk of incident CVD, MACE, MI events in healthy older adults. This highlighted UA as a potential modifiable risk factor, warranting future studies on UA-lowering medication in CVD primary prevention.