Hyperuricemia as a Risk Factor in Coronary Heart Disease

Summary

The subjects of this study were 290 hospital patients who were divided into 4 groups: acute myocardial infarction (100), cardiac ischaemia with angina but no infarction (50), white patients without evidence of coronary heart disease (70), and a group of South African black patients without detectable coronary heart disease (70). Mean serum uric acid (SUA) levels were 8,08 ± 0,32 in the ischaemic group, 7,09 ± 0,23 in the acute infarction group, 5,78 ± 0,21 in normal black patients, and 5,75 ± 0,21 in normal white controls. The differences in SUA levels between the ischaemic and infarction groups as compared with both control groups was highly significant (p < 0,00l). These differences were most striking in the females aged 60 years and over.

Patients receiving diuretics, uricosuric and uricosuppressive agents were excluded from the study.

Wide racial differences in incidence and mortality from coronary heart disease (CHD) exist, and one of the greatest contrasts is found in the South African multi-racial society. The mortality rate is high in whites and extremely low amongst the black population.

Despite lack of proof that the association is causal, further investigation of SUA levels in CHD, with emphasis upon possible interrelationships between age, sex, and racial factors, appears to be indicated.

There are wide differences in incidence and mortality from CHD among white and non-white populations in different parts of the world. South Africa is one such country, where mortality from CHD among the white population exceeds 40% of all deaths, whereas mortality from this disease amongst the South African black population is extremely low. Nlither of these extremes of mortality have been wholly explained.¹

A recent personal study showed that, as a possible associated risk factor, hyperuricaemia correlated strongly with the occurrence of acute myocardial infarction.² The present study was undertaken in an attempt to study further the possible relationship, if any, between high SUA levels, and the development of myocardial infarction. On the assumption that hyperuricaemia is essentially a generalized metabolic disease, and because of the lack of evidence that the relationship was causal, well-defined control groups have been included in the study.