Teasing Relationships Between Uric Acid, Fructose, and Hypertension
February 1, 2016 less than 1 minute read
SOURCE: Madero M, et al. A pilot study on the impact of a low fructose diet and allopurinol on clinic blood pressure among overweight and prehypertensive subjects: a randomized placebo controlled trial. J Am Soc Hypertens 2015;9:837-844.
Uric acid has been under scrutiny for decades since its identification as a cardiovascular risk factor in the Framingham Heart Study. Whether elevations in uric acid are causally related to cardiovascular disease continues to be hotly debated. Elevations of plasma and intracellular uric acid are associated with higher blood pressure. Similarly, fructose, especially high-fructose corn syrup, has been suspect for its contribution to metabolic syndrome. Since fructose leads to increased intracellular and serum uric acid, a plausible pathologic pathway is evident.
Madero et all performed a two-step, controlled trial among 72 obese prehypertensive patients to examine the sequential effect of restricted dietary fructose for 4 weeks, followed by the addition of allopurinol 300 mg/day for another 4 weeks, compared to a control group. All subjects were advised to restrict sodium.
There was a trend for greater blood pressure reduction in the low-fructose diet group that did not achieve statistical significance. A post-hoc analysis of the second step of the trial (adding allopurinol to the diet) produced a reduction in office systolic blood pressure compared to the control group, but not in systolic blood pressure as measured by ambulatory blood pressure monitoring, which is considered more accurate and a better predictor of adverse effects of blood pressure. The roles of fructose restriction and allopurinol need more clarification.
The roles of fructose restriction and allopurinol need more clarification.
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