Table 1. Characteristics of Cohort Studies of Hyperuricemia and Coronary Heart Disease.
| Reference, publication (yr) | Country/Population | Participants (% males) | Age range or mean (yr) | Follow-up (yr) | Hyperuricemia Assessment (mg/dl) | No. of total CHD cases | Outcome Ascertainment | Variables controlled | Study quality |
|---|---|---|---|---|---|---|---|---|---|
| CHD INCIDENCE | |||||||||
| Freedman et al.31 1995 | United States | 5421 (46) | 25–74 | 13.5 | 7 (C); per 1 mg/dl increase | 403 (M) 286 (F) | Based on hospital records and death certificates | Age, race, cholesterol, DBP, smoking, alcohol, education level, and use of antihypertensive and diuretic meds | 9 |
| Goldberg et al.32 1995 | United States | 2710 (100) | 55–64 | 23 | 6.8 (M) | 352 (M) | Based on autopy reports and/or medical records such as EKGs and cardiac enzymes | Age | 8 |
| Liese et al.33 1999 | Germany/European | 960 (100) | 45–64 | 8 | 6.3 (M) | 55 (M) | Based on medical records such as clinical symptoms, EKGs, cardiac enzymes, and autopsy reports | Age, alcohol, cholesterol/HDL ratio, HTN, smoking, BMI, education, and use of diuretics | 9 |
| Culleton et al.34 1999 | United States | 6763 (45.5) | 47 ± 15 | 17.4 | 6.8 (M) 6.3 (F) | 394 (M) 223 (F) | Based on medical records such as clinical symptoms, EKGs, and cardiac enzymes | Age, BMI, SBP, use of antihypertensive and diuretic meds, DM, cholesterol, alcohol, smoking, LVH, and menopausal status | 9 |
| Moriarity et al.35 2000 | United States | 13504 (43.7) | 45–64 | 8 | 7.6 (M); 6.3 (F) | 264 (M) 128 (F) | Based on medical records such as clinical symptoms, EKGs, and cardiac enzymes, and data on death certificates | Age, race, ARIC center, smoking, LDL, SBP, BMI, HDL, DM, waist/hip ratio, protein, TG, alcohol, and antihypertensive meds | 9 |
| Puddu et al.36 2001 | Italy/European | 2469 (45.2) | 35–74 | 6 | 7.3 (C) | 68 (M) 41 (F) | Based on paper/phone questionnaires, EKGs, and medical records | Age, sex, SBP, cholesterol, DM, smoking, and BMI | 9 |
| Chien et al.37 2005 | China/Asian | 3602 (47) | ≥35 | 8.5 | 7.7 (M); 6.6 (F) | 86 | Based on death certificates and hospital records | Age, SBP, BMI, DM, cholesterol, smoking, and alcohol | 9 |
| Wheeler et al.10 2005 | Iceland/European | 6042 (70.3) | 56 ± 9 | 17.5 | 5.7 (M); 4.7 (F) | 2080 | Based on questionnaires, EKGs, and medical records | Age, smoking, SBP, cholesterol, BMI, TG, FEV1, and DM | 9 |
| Bos et al.38 2006 | Netherlands/European | 4385 (35.4) | ≥55 | 8.4 | 6.4 (M); 5.4 (F); 6.5 (C) | 515 | Based on ICD-9 codes on medical records | Age, sex, SBP, cholesterol, HDL, DM, smoking, diuretic use, and waist/hip ratio | 9 |
| Krishnan et al.39 2006 | United States | 12866 (100) | 46 ± 6 | 6.5 | 7.0 (M) | 1108 (M) | Based on review of medical records such as EKGs and CABG surgery | Age, BP, cholesterol, serum creatinine, DM, smoking, BMI, family history of AMI, alcohol, aspirin and diuretic use | 9 |
| Baba et al.40 2007 | Japan/Asian | 2024 (38.3 | 62 ± 9.9 (M); 63.2 ± 8.4 (W) | 8 | 7.0 (C) | 49 | Based on self-reports, EKGs, and medical records | Age, sex, smoking, alcohol, DM, and fatty liver | 9 |
| Meisinger et al.41 2008 | Germany/European | 3424 (100) | 45–74 | 11.7 | 6.6 (M) | 297 (M) | Based on the population based data from coronary event registry and death certificates | Age, smoking, alcohol, physical activity, HTN, BMI, DM, CRP dyslipidemia, creatinine, and diuretic use | 9 |
| Kavousi et al.13 2012 | Netherlands/European | 5933 (40.6) | 69.1 ± 8.5 | 6.8 | 5.0 (C) | 347 | Based on ICD-9 codes on medical records | Age, sex, BMI, SBP, treatment of HTN, total and HDL cholesterol levels, use of lipid-lowering medication, smoking, and DM | 9 |
| Storhaug et al.14 2013 | Norway/European | 5700 (47.3) | 55–75 | 12.5 | 6.0 (M); 5.7(F); per 1.5 mg/dl increase | 659 | Based on death certificates and hospital records | Age, BMI, SBP/DBP, HDL/TC, use of diuretics and other antihypertensive meds, smoking, physical activity, and renal factors | 9 |
| CHD MORTALITY | |||||||||
| Levine et al.42 1989 | United States | 4825 (0) | 45–64 | 11.5 | Per 1 mg/dl increase | 23 (F) | Based on ICD-8 codes on death certificates; autopsy and hospital reports if available | Age, weight, smoking, DBP, cholesterol, and antihypertensive meds | 9 |
| Fang et al.43 2000 | United States | 5926 (45.6) | 25–74 | 16.4 | 7.0 (M); 5.6 (F); Per 1 mg/dl increase | 222 (M); 172 (F) | Based on ICD-9 codes on death certificates; hospital records if available | Age, cholesterol, race, BMI, smoking, alcohol, HTN, DM, and sex | 9 |
| Tomita et al.44 2000 | Japan/Asian | 49413 (100) | 25–60 | 5.4 | 6.5 (M) | 85 (M) | Based on ICD-9 codes on health and pension records | Age | 8 |
| Eboule et al.45 2001 | Belgium/European | 9701 (53.9) | 25–74 | 10 | 7.0 (M); 5.4 (F) | 150 (M) 51 (F) | Based on ICD-9 codes on hospital records | Age, DBP, education level, smoking, and alcohol (M); age, cholesterol, SBP, smoking, BMI, alcohol and DM (F) | 9 |
| Jee et al.46 2004 | Korea/Asian | 22698 (100) | 30–77 | 9 | 7.0 (M) | 99 (M) | Based on ICD-9 and 10 codes from hospitalization records and death certificates | Age, HTN, DM, cholesterol, and smoking | 9 |
| Hakoda et al.47 2005 | Japan/ Asian | 10615 (36.4) | 49 | 24.9 | 7.0 (M); 6.0 (F) | 177 (M) 250 (F) | Based on ICD-7 through 10 codes on death certificates | Age, BMI, smoking, alcohol, SBP, cholesterol, HTN, DM, kidney disease, malignant tumor, and estimated radiation dose from the atomic bombs | 9 |
| Baibas et al.48 2005 | Greece/European | 1198 (42) | ≥25 | 14 | per 1 mg/1dl increase | 34 (M) 33 (F) | Based on ICD-9 codes on death certificates | Age, body weight, smoking, alcohol, DM, SBP, cholesterol, village, TG, and educational level | 9 |
| Gerber et al.49 2006 | Israel/Asian | 9125 (100) | 49 | 23 | 5.6 (M) | 830 (M) | Based on ICD-9 codes on death certificates and hospital records | Age, BMI, SBP, DM, cholesterol, smoking, and LVH on EKG | 9 |
| Krishnan et al.50 2008 | United States | 9105 (100) | 41–63 | 17 | 7.0 (M) | 833 (M) | Based on ICD-9 and 10 codes on death certificates | Age, SBP/DBP, cholesterol, BMI, TG, serum creatinine, DM, alcohol, smoking, family history of AMI, aspirin and diuretic use | 9 |
| Strasak et al.51 (M) 2008 | Austria/European | 83683 (100) | 41.6 | 12.4 | 6.8 (M) | 844 (M) | Based on ICD-9 and 10 codes on death certificates autopsy records; if available | Age, BMI, cholesterol, SBP/DBP, TG, GGT, smoking, and year of examinations | 9 |
| Strasak et al.52 (F) 2008 | Austria/European | 28613 (0) | 62.3 | 21 | 5.4 (F) | 518 (F) | Based on ICD-9 and 10 codes on death certificates; autopsy records; if available | Age, BMI, cholesterol, SBP/DBP, TG, GGT, smoking, DM, occupational status, and year of examinations | 9 |
| Holme et al.53 2009 | Sweden/European | 417734 (53) | 30–85 | 11.8 | 6.1 (M); 5.5 (F); per 1 mg/dl increase | 12286 (M) 4888 (F) | based on ICD-7, ICD-8, ICD-9, ICD-10, hospital records and the cause-of-death register | Age, sex, TC, TG, HTN, DM | 9 |
| Chen et al.54 2009 | China/Asian | 90393 (46.3) | 51.5 | 8.2 | 7.0 (M, F); per 1 mg/dl increase | 286 | Based on ICD-9 codes on death certificates | Age, sex, BMI, cholesterol, DM, TG, HTN, smoking, and alcohol | 9 |
| Chuang et al.15 2012 | China/Asian | 128569 (46.6) | ≥20 | 7.33 | 7.0 (M); 6.0 (F) | 2049 | Based on ICD-9 codes on death certificates and hospital records | Age, SBP/DBP, drugs using for HTN, diuretics using, BMI, TG, TC, DM, smoking, alcohol, physical activity, and working type | 9 |
| Zalawadiya et al.16 2015 | United States | 11009 (unclear) | 25–74 | 14.5 | 6.3 (C); per 1 mg/dl increase | 458 | Based on ICD-10 codes on death certificates; hospital records if available | Age, sex, race, BMI, SBP, smoking, HDL, cholesterol, antihypertensive meds, CRP, eGFR | 9 |
CHD, coronary heart disease; M. male; F, female; C, combined; CT, computer tomography; LDL, low-density lipoprotein; TC, total cholesterol; TG, triglycerides HDL, high-density lipoprotein; BMI, body mass index; HTN, hypertension; DM, diabetes mellitus; EKG, electrocardiogram; CRP, c-reactive protein; GGT, gamma-glutamyl transferase; LVH, left ventricular hypertrophy; AMI, acute myocardial infarction; SBP, systolic blood pressure; DBP, diastolic blood pressure; BP, blood pressure; eGFR, estimated glomerular filtration rate; FEV1, forced expiratory volume in one second; CABG, coronary artery bypass graft; ICD, International Classification of Diseases; ARIC, Atherosclerosis Risk in Communities.