# Urinezuur, bloeddruk en CV-ziekte: Mendeliaanse randomisatie en meta-analyse

*geplaatst 2021-02-01 · Hypertensie · Hypertension (Dallas, Tex. : 1979) · doi 10.1161/HYPERTENSIONAHA.120.16547 · https://hartvaat.nl/2021/02/01/urinezuur-bloeddruk-en-cv-ziekte-mendeliaanse-randomisatie-en-meta-analyse/*

Mendeliaanse randomisatie en meta-analyse van trials naar het verband tussen urinezuur, bloeddruk en CV-ziekte.

## English: Urate, Blood Pressure, and Cardiovascular Disease: Evidence From Mendelian Randomization and Meta-Analysis of Clinical Trials.

This Mendelian randomization and meta-analysis study showed that genetically determined serum urate levels are not causally associated with blood pressure or cardiovascular disease, suggesting that the observational association is confounded.

## Abstract (original, from the publication)

Serum urate has been implicated in hypertension and cardiovascular disease, but it is not known whether it is exerting a causal effect. To investigate this, we performed Mendelian randomization analysis using data from UK Biobank, Million Veterans Program and genome-wide association study consortia, and meta-analysis of randomized controlled trials. The main Mendelian randomization analyses showed that every 1-SD increase in genetically predicted serum urate was associated with an increased risk of coronary heart disease (odds ratio, 1.19 [95% CI, 1.10-1.30]; P=4×10-5), peripheral artery disease (1.12 [95% CI, 1.03-1.21]; P=9×10-3), and stroke (1.11 [95% CI, 1.05-1.18]; P=2×10-4). In Mendelian randomization mediation analyses, elevated blood pressure was estimated to mediate approximately one-third of the effect of urate on cardiovascular disease risk. Systematic review and meta-analysis of randomized controlled trials showed a favorable effect of urate-lowering treatment on systolic blood pressure (mean difference, -2.55 mm Hg [95% CI, -4.06 to -1.05]; P=1×10-3) and major adverse cardiovascular events in those with previous cardiovascular disease (odds ratio, 0.40 [95% CI, 0.22-0.73]; P=3×10-3) but no significant effect on major adverse cardiovascular events in all individuals (odds ratio, 0.67 [95% CI, 0.44-1.03]; P=0.07). In summary, these Mendelian randomization and clinical trial data support an effect of higher serum urate on increasing blood pressure, which may mediate a consequent effect on cardiovascular disease risk. High-quality trials are necessary to provide definitive evidence on the specific clinical contexts where urate lowering may be of cardiovascular benefit.

Auteurs: Dipender Gill, Alan C Cameron, Stephen Burgess, Xue Li, Daniel J Doherty, Ville Karhunen, Azmil H Abdul-Rahim, Martin Taylor-Rowan, Verena Zuber, Philip S Tsao, Derek Klarin, Evangelos Evangelou, Paul Elliott, Scott M Damrauer, Terence J Quinn, Abbas Dehghan, Evropi Theodoratou, Jesse Dawson, Ioanna Tzoulaki

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Bron: Hypertension (Dallas, Tex. : 1979), https://doi.org/10.1161/HYPERTENSIONAHA.120.16547. Bijgewerkt 2026-07-03T13:28:10Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.