Association of the uric acid to high-density lipoprotein cholesterol ratio with CVD mortality in Chinese hypertensive populations: a prospective cohort study

Uric acid to high-density lipoprotein cholesterol ratio (UHR) is a novel index of metabolism and inflammation proposed by recent studies. The predictive value of UHR has been validated in non‑alcoholic fatty liver disease. However, the association of UHR is undetermined in patients with hypertension. The aim of this study was to investigate the association of UHR with all-cause mortality and CVD mortality in patients with hypertension. This study was conducted in a real-world setting using data from a large-scale, population-based registry in China. The outcome was all-cause and CVD mortality. Cox proportional hazards models were used to investigate the associations between UHR and mortality from all-causes and cardiovascular. Penalized spline method, the Kaplan-Meier method, and subgroup analyses were also used. 13719 patients with hypertension were included in the study. During a median follow-up of 4.3 years,772 all-cause mortality occurred, with 378 CVD mortality. The mean baseline UHR was 12.53 ± 5.34. Overall, higher UHR was conspicuously associated with an elevated risk of CVD mortality and all cause mortality. Accordingly, compared with participants in quartiles 1, a conspicuous higher risk of all-cause mortality (HR = 1.52, 95% CI: 1.15, 2.01) and CVD mortality (HR = 2.54, 95% CI: 1.63,3.95) were found in quartile 4. No significant interactions were found in any of the subgroups. Among Chinese adults with hypertension, an elevated UHR predicted increased risk of all-cause and CVD mortality in patients.