Abstract
BACKGROUND: Atrial fibrillation (AF) and hypertension are associated with inflammatory response and oxidative stress. Uric acid (UA) is the product of the oxidative reaction and a surrogate indicator of oxidative stress. However, whether UA imposes a greater risk of AF in hypertensive patients remains unclear. This study sought to evaluate the evidence supporting an association between serum uric acid (SUA) and AF in patients with hypertension. METHODS: The observational studies in which SUA was measured and AF was reported in hypertension were searched for in the PubMed, Cochrane Library, EMBASE, and Web of Science databases until December 31, 2023, without language restrictions. We calculated the pooled mean difference of SUA between those with and without AF in the hypertension patients. RESULTS: A total of 5 studies were included. Three cross-sectional studies comprised 4191 patients with hypertension. The standardized mean difference (SMD) of SUA for those with AF was 0.60 (95% confidence interval (CI) 0.15-1.05) compared with those without AF. Two cohort studies evaluated 9810 individuals with hypertension, and the risk of AF was 0.03 (95% CI -0.05-0.11), which revealed no significant difference between high SUA and normal SUA. CONCLUSION: Our findings demonstrate a significant association between SUA and AF in patients with hypertension. Further studies are needed to investigate the underlying pathophysiological mechanisms and to assess the value of SUA as a marker or a potential target for the therapy of AF in patients with hypertension.