Validation of age- and sex-dependent association of uric acid and incident hypertension in rural areas

BACKGROUND: A previous study based on urban areas suggested the age- and sex-dependent association of uric acid (UA) and incident hypertension. We aimed to investigate whether this association is valid even in rural areas with different lifestyle. METHODS: Data from the cardiovascular disease association study, a prospective cohort study based on rural residents, was analyzed. A total of 4,592 subjects (mean age, 60.1 ± 9.5 years; men, 37.7%) without hypertension were included. We first investigated whether UA was a risk factor for incident hypertension using Cox regression, and then compared the relative risk by stratification according to age and sex. RESULTS: During the follow-up period (mean, 2.0 years), 579 subjects (12.6%) were newly diagnosed with hypertension. The risk factors for incident hypertension were age (Hazard ratios [HR] for ≥ 65, 1.26), systolic blood pressure (HR per 1 mmHg increase, 1.07), and serum UA concentration (HR per 1 mmHg increase, 1.10). The risk of UA-related incident hypertension was higher in the non-elderly than in the elderly for both men and women (HR, 1.74 for non-elderly men; 1.88 for non-elderly women; 1.66 for elderly men; 1.10 for elderly women). Even after adjusting for multiple confounders, the risk of UA-related incident hypertension was significantly higher in non-elderly women (HR, 1.59; P < 0.05). CONCLUSIONS: Age- and sex-dependent association of UA with incident hypertension suggested in cohort study based on urban areas was consistently found in rural areas as well. In particular, non-elderly women were at a higher risk for UA-related incident hypertension. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40885-022-00206-5.