Allopurinol and Cardiovascular Outcomes in Adults With Hypertension
Open accessAbstract
Allopurinol lowers blood pressure in adolescents and has other vasoprotective effects. Whether similar benefits occur in older individuals remains unclear. We hypothesized that allopurinol is associated with improved cardiovascular outcomes in older adults with hypertension. Data from the United Kingdom Clinical Research Practice Datalink were used. Multivariate Cox-proportional hazard models were applied to estimate hazard ratios for stroke and cardiac events (defined as myocardial infarction or acute coronary syndrome) associated with allopurinol use over a 10-year period in adults aged >65 years with hypertension. A propensity-matched design was used to reduce potential for confounding. Allopurinol exposure was a time-dependent variable and was defined as any exposure and then as high (≥300 mg daily) or low-dose exposure. A total of 2032 allopurinol-exposed patients and 2032 matched nonexposed patients were studied. Allopurinol use was associated with a significantly lower risk of both stroke (hazard ratio, 0.50; 95% confidence interval, 0.32–0.80) and cardiac events (hazard ratio, 0.61; 95% confidence interval, 0.43–0.87) than nonexposed control patients. In exposed patients, high-dose treatment with allopurinol (n=1052) was associated with a significantly lower risk of both stroke (hazard ratio, 0.58; 95% confidence interval, 0.36–0.94) and cardiac events (hazard ratio, 0.65; 95% confidence interval, 0.46–0.93) than low-dose treatment (n=980). Allopurinol use is associated with lower rates of stroke and cardiac events in older adults with hypertension, particularly at higher doses. Prospective clinical trials are needed to evaluate whether allopurinol improves cardiovascular outcomes in adults with hypertension.
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A meta-analysis of interventional studies has shown that uric acid-lowering treatment using allopurinol lowers BP.
“Nonetheless, a meta-analysis of interventional studies has shown that uric acid-lowering treatment using allopurinol lowers BP210).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [210]
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- Authors
- MacIsaac, R. L., Salatzki, J., Higgins, P., Walters, M. R., Padmanabhan, S., Dominiczak, A. F., Touyz, R. M., & Dawson, J.
- Affiliations
- Charité – Universitätsmedizin Berlin (DE)
- ORCID
- Venue
- Hypertension
- Published
- 2016-03
- Volume
- 67
- Issue
- 3
- Pages
- 535-540
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2230815054
- Cited by
- 124
- References
- 36
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 13 · 2023: 15 · 2022: 12 · 2021: 6 · 2020: 13 · 2019: 13 · 2018: 13 · 2017: 15 · 2016: 15
- FWCI
- 18.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Funders
- British Heart Foundation (RG/13/7/30099)
- Topics
- Health Sciences › Medicine › Nephrology › Gout, Hyperuricemia, Uric Acid
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Keywords
- allopurinol, stroke, myocardial infarction, acute coronary syndrome, cardiovascular outcomes, older adults, vasoprotective effects, dose-response relationship, xanthine oxidase inhibition
- MeSH terms
- Adolescent, Adult, Aged, Allopurinol, Antimetabolites, Blood Pressure, Dose-Response Relationship, Drug, Female, Follow-Up Studies, United Kingdom, Humans, Hypertension, Male, Middle Aged, Myocardial Infarction, Prognosis, Prospective Studies, Risk Factors, Incidence, Stroke, Young Adult
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