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Hypertension and asymptomatic hyperuricemia: algorithm of diagnostics and management (literature review)

Objective. To determine the diagnostic criteria for asymptomatic hyperuricemia as a cardiovascular risk factor, the need for antihypertensive therapy and urate-reducing therapy in patients with hypertension; to develop an algorithm for the management of hypertensive patients with asymptomatic hyperuricemia. Search strategy and methodology. The following key words were used for the search: “asymptomatic hyperuricemia” and “hypertension” in four databases — PubMed, Medscape, E-library Yandex.ru. Results. The review included 79 sources, including 1 monograph, 11 international and Russian guidelines, consensus documents, 67 reviews, observational, non-randomized, randomized clinical trials, their meta-analyses, requirements for uric acid blood tests. The review presents a definition, prevalence and diagnostic criteria for asymptomatic hyperuricemia, depending on the assessment method and factors affecting the concentration of uric acid, as well as the pathogenetic mechanisms of hyperuricemia. The linear relationship between uric acid level with the risk of hypertension, dyslipidemia, cardiovascular diseases and complications. The review discusses drug-induced hyperuricemia, the effect of various antihypertensive and lipid-lowering drugs on the blood concentration of uric acid, the indications for urate-reducing therapy in asymptomatic hyperuricemia. Conclusions. An algorithm for the management of patients with asymptomatic hyperuricemia and hypertension is proposed.