Uric acid levels predict mortality in older adults

Serum uric acid (SUA) is significantly associated with all-cause and cardiovascular (CV) mortality in older adults, with substantial age-related differences, reports a study. The risk of death increases with higher SUA levels in individuals aged 65‒74 years, with a prognostic threshold of 4.8 mg/dl.

In addition, the association between SUA and mortality showed a J-shaped pattern in oldest participants, according to the researchers.

This study sought to examine the relationship of SUA with all-cause and CV mortality in older adults participating in the large multicentre observational uric acid right for heart health (URRAH) study. A total of 8,000 URRAH participants aged ≥65 years were included in this analysis.

The researchers used Cox regression models, stratified according to the cutoff age of 75 years, to assess the predictive role of SUA. SUA was tested as continuous and categorical variable (age-specific quartiles). Receiver operating characteristic curves were used to examine the prognostic threshold of SUA for mortality.

On multivariate Cox regression analysis adjusted for CV risk factors and comorbidities, SUA was independently associated with both all-cause mortality (hazard ratio [HR], 1.169, 95 percent confidence interval [CI], 1.107‒1.235) and CV mortality (HR, 1.146, 95 percent CI, 1.064‒1.235) among participants aged 65‒74 years. The cutoff value of 4.8 mg/dl discriminated mortality status.

Among those aged ≥75 years, a J-shaped relationship was observed between SUA and all-cause and CV mortality, with the risk increasing at extreme levels of SUA.

“Large interventional studies are needed to clarify the benefits and possible risks of urate-lowering treatments in older adults,” the researchers said.