Uric Acid, Arterial Stiffness and Blood Pressure: A Population‐Based Cohort Study

ABSTRACT Background and Aim Serum uric acid (SUA) has long been linked to elevated blood pressure (BP) in observational clinical studies. Nonetheless, data regarding the correlation between SUA and BP are controversial in randomized controlled trials and mendelian randomization research. Furthermore, it is yet unknown if there is a reciprocal relationship between SUA and BP. This study was conducted to explore the temporal relationship between SUA and BP and related risk factors. Methods In this cohort study, 27,581 participants free of hypertension and cardiovascular disease from 2010 to 2016 in the Kailuan study were included. Cross‐lagged studies with repeated evaluation of BP and SUA were applied to identify the temporal relationship between SUA and BP. The brachial‐ankle pulse wave velocity (baPWV) and high‐sensitivity C‐reactive protein (hs‐CRP) were conducted to evaluate the mediation impact on the correlation between SUA and BP among 6761 participants via mediation analysis. Results The cross‐lagged path coefficient of baseline SUA and follow‐up systolic BP (β2) was 0.06 (95% CI, 0.03–0.08) in the participants with the age of ≤ 45 ( n = 12,244), which was greater versus the coefficient of baseline systolic BP and follow‐up SUA (β1) 0.04 (95% CI, 0.01–0.07; p < 0.001), in contrast to the participants with the age of > 45 ( n = 15337). The positive correlation between SUA and BPs was mediated by baPWV. Conclusion SUA may be a precursor to raised BP in young men, vascular stiffness mediated the positive correlation between BP and SUA. Trial Registration ChiCTR‐TNC‐11001489.