Uric Acid: A Missing Link between Hypertensive Pregnancy Disorders and Future Cardiovascular Disease?

Objective To determine whether women who had a hypertensive pregnancy disorder (HPD) have elevated uric acid concentrations decades after pregnancy as compared with women who had normotensive pregnancies. Patients and Methods The Genetic Epidemiology Network of Arteriopathy study measured uric acid concentrations in Hispanic (30%), non-Hispanic white (28%), and non-Hispanic black (42%) women (mean age, 60±10 years). This cross-sectional study was conducted between July 1, 2000, and December 31, 2004. Hispanic participants were recruited from families with high rates of diabetes, whereas non-Hispanic participants were recruited from families with high rates of hypertension. This analysis compared uric acid concentrations in women with a history of normotensive (n=1846) or hypertensive (n=408) pregnancies by logistic regression. Results Women who had an HPD had higher uric acid concentrations (median, 5.7 mg/dL vs 5.3 mg/dL; P<.001) and were more likely to have uric acid concentrations above 5.5 mg/dL (54.4% vs 42.4%; P=.001) than were women who had normotensive pregnancies. These differences persisted after adjusting for traditional cardiovascular risk factors, comorbidities, and other factors that affect uric acid concentrations. A family-based subgroup analysis comparing uric acid concentrations in women who had an HPD (n=308) and their parous sisters who had normotensive pregnancies (n=250) gave similar results (median uric acid concentrations, 5.7 mg/dL vs 5.2 mg/dL, P=0.02; proportion of women with uric acid concentrations >5.5 mg/dL, 54.0% vs 40.3%, P<.001). Conclusion Decades after pregnancy, women who had an HPD have higher uric acid concentrations. This effect does not appear to be explained by a familial predisposition to elevated uric acid concentrations.