Abstract Title:

Folic acid therapy reduces serum uric acid in hypertensive patients: a substudy of the China Stroke Primary Prevention Trial (CSPPT).

Abstract Source:

Am J Clin Nutr. 2017 Feb 1. Epub 2017 Feb 1. PMID: 28148501

Abstract Author(s):

Xianhui Qin, Youbao Li, Mingli He, Genfu Tang, Delu Yin, Min Liang, Binyan Wang, Jing Nie, Yong Huo, Xin Xu, Fan Fan Hou

Article Affiliation:

Xianhui Qin


BACKGROUND: The effect of folic acid supplementation on uric acid (UA) concentrations is still inconclusive.

OBJECTIVE: We aimed to test the efficacy of folic acid therapy in reducing serum UA in hypertensive patients.

DESIGN: A total of 15,364 hypertensive patients were randomly assigned to a double-blind daily treatment with a single tablet that contained 10 mg enalapril and 0.8 mg folic acid (n = 7685) or 10 mg enalapril alone (n = 7679). The main outcome was the change in serum UA, which was defined as UA at the exit visit minus that at baseline. Secondary outcomes were as follows: 1) controlled hyperuricemia (UA concentration<357μmol/L after treatment) and 2) new-onset hyperuricemia in participants with normal UA concentrations (<357μmol/L).

RESULTS: After a median of 4.4 y of treatment, the mean± SD UA concentration increased by 34.7 ± 72.5 μmol/L in the enalapril-alone group and by 30.7 ± 71.8 μmol/L in the enalapril-folic acid group, which resulted in a mean group difference of -4.0 μmol/L (95% CI: -6.5, -1.6 μmol/L; P = 0.001). Furthermore, compared with enalapril alone, enalapril-folic acid treatment showed an increase in controlled hyperuricemia (30.3% compared with 25.6%; OR: 1.31; 95% CI: 1.01, 1.70) and a decrease in new-onset hyperuricemia (15.0% compared with 16.3%; OR: 0.89; 95% CI: 0.79, 0.99). A greater beneficial effect was observed in subjects with hyperuricemia(P-interaction = 0.07) or higher concentrations of total homocysteine (tHcy) (P-interaction = 0.02) at baseline. Furthermore, there was a significant inverse relation (P<0.001) between the reduction of tHcy and the change in UA concentrations.

CONCLUSIONS: Enalapril-folic acid therapy, compared with enalapril alone, can significantly reduce the magnitude of the increase of UA concentrations in hypertensive adults. This trial was registered at clinicaltrials.gov as NCT00794885.

Study Type : Human Study
Additional Links
Pharmacological Actions : Uricosuric Agents : CK(205) : AC(44)

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