Serum Uric Acid and Mortality Form Cardiovascular Disease: EPOCH-JAPAN Study
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AIM: To investigate the relationship between serum uric acid levels and cardiovascular disease in Asians. METHODS: We examined the above relationship using the data of Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN Study). The data of 36,313 subjects (15,628 men and 20,685 women aged 35-89 years without histories of stroke, coronary heart disease, or cancer at baseline) were used for the analyses. Sex-specific hazard ratios (HRs) of mortality from cardiovascular disease were estimated according to the quintiles of serum uric acid using Cox hazard models stratified by cohorts. RESULTS: During 441,771 person-years of follow-up, we documented 1,288 cardiovascular deaths. A J- or U-shaped relationship between serum uric acid level and cardiovascular disease mortality was observed. Compared with the lowest quintile of serum uric acid levels, the highest quintile was associated with an increased cardiovascular disease mortality in men [HR: 1.28; 95% confidence interval (CI): 1.01-1.63] and women (HR: 1.51; 95% CI: 1.14-1.99). However, there was no significant association with mortality from stroke, coronary heart disease or heart failure in both men and women. CONCLUSION: This large pooled analysis in Japan suggested a J- or U-shaped relationship between serum uric acid levels and cardiovascular mortality. The highest quintile of serum uric acid levels was associated with increased cardiovascular disease mortality in both Japanese men and women.
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Hyperuricemia can be regarded as a risk factor for ASCVD.
“[Statement]Hyperuricemia can be regarded as a risk factor for ASCVD. (Evidence level: E2)”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [208]
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- Authors
- Zhang, W., Iso, H., Murakami, Y., Miura, K., Nagai, M., Sugiyama, D., Ueshima, H., Okamura, T., & EPOCH-JAPAN GROUP
- Affiliations
- Fukushima Medical University (JP)
- The University of Osaka (JP)
- Toho University (JP)
- Shiga University of Medical Science (JP)
- Keio University (JP)
- ORCID
- Venue
- Journal of Atherosclerosis and Thrombosis
- Publisher
- Japan Atherosclerosis Society
- Published
- 2016
- Volume
- 23
- Issue
- 6
- Pages
- 692-703
- ISSN
- 1340-3478 (ISSN-L)
- 1880-3873
- PMC
- PMC5221499
- OpenAlex
- W2337745131
- Cited by
- 127
- References
- 40
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 10 · 2023: 11 · 2022: 17 · 2021: 23 · 2020: 30 · 2019: 7 · 2018: 3 · 2017: 8 · 2016: 4
- FWCI
- 7.37
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Journal of Atherosclerosis and Thrombosis (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Institutional Repositories DataBase (IRDB) (submittedVersion)
- Funders
- National Cerebral and Cardiovascular Center (22-4-5)
- Keio University
- Dokkyo Medical University
- Ministry of Health, Labour and Welfare
- Jichi Medical University
- Hokkaido University
- Fujita Health University
- Topics
- Health Sciences › Medicine › Nephrology › Gout, Hyperuricemia, Uric Acid
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
- Keywords
- serum uric acid, cardiovascular mortality, J-shaped association, U-shaped relationship, sex differences, stroke mortality, coronary heart disease mortality, heart failure mortality, Japanese adults
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cardiovascular Diseases, Female, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Sex Factors, Uric Acid, Biomarkers, Survival Rate
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