Animal models have shown that acute elevations of serum
urate (e.g., by inhibition of uricase) induce a prompt rise in
blood pressure and that chronic urate elevation maintains
the rise in pressure and induces irreversible vascular damage
and glomerular changes, and results in a form of saltsensitive
hypertension [25,26]. The mechanisms suggested
are a renin-angiotensin-aldosterone-dependent arteriolopathy,
inhibition of neuronal nitric oxide synthase, and
interstitial fibrosis and glomerulosclerosis with albuminuria.
A meta-analysis of 11 studies showed that hyperuricaemia
is associated with an increased risk of incident
hypertension, independent of traditional risk factors. This
risk appears more pronounced in younger individuals
(with pre-hypertension) and in women [27]. In adults with
essential hypertension an association with hyperuricaemia
is very common.