# Sex- and country-specific associations of hyperuricemia and inflammation with vascular aging across populations with diverse cardiovascular risks

## TL;DR

This study shows that high uric acid and inflammation are linked to vascular aging, but these links vary by sex and country.

## Contribution

The study reveals sex- and country-specific associations between hyperuricemia, inflammation, and vascular aging.

## Key findings

- High uric acid was linked to vascular aging in Swedish men and Lithuanian women.
- Inflammation (hs-CRP) was associated with vascular aging only in Swedish men.
- Associations varied by sex and country, suggesting context-specific interpretations.

## Abstract

The importance of measuring vascular age has been emphasized in numerous studies, highlighting its critical role in precision medicine. This cross-sectional heterogeneity exploration study examined sex- and country-specific association of serum uric acid (SUA) and inflammation, measured as high sensitivity C-reactive protein (hs-CRP), and vascular aging across populations with diverse cardiovascular risks.

This work analyzed data from three cohorts: 4,802 individuals from Sweden (SCAPIS – The Swedish CArdioPulmonary bioImage Study, n = 3,255), Lithuania (LitHiR – The Lithuanian High Cardiovascular Risk Prevention Program, n = 708), and Spain (The Sagunto Cohort, n = 838). Standard clinical and laboratory variables were used; aortic stiffness measured via carotid-femoral pulse wave velocity (cfPWV) (Sphygmocor), employing the foot-to-foot method in the right carotid and femoral arteries. In addition. Sex disaggregated analysis was performed.

The study involved individuals with a mean age of 56 (±8) years, 53% women, 48% never smokers, 41% with hypertension, and 20% with diabetes. In adjusted for cardiometabolic factors linear models, hs-CRP was associated with cfPWV only in Swedish men (p = 0.007), while SUA was associated with cfPWV in Swedish men (p = 0.001) and Lithuanian women (p = 0.029). In logistic regression, SUA predicted higher odds of cfPWV >10 m/s in Swedish men (OR 1.003, p = 0.041), and in Lithuanian women this prediction was of borderline significance (OR 1.004, p = 0.065). In Spanish women, the association with SUA was negative and of borderline significance (OR 0.995, p = 0.067). hs-CRP was not associated with cfPWV >10 m/s in adjusted models.

This cross-sectional exploratory study provides evidence that SUA and hs-CRP are associated with vascular aging, although their predictive value should be interpreted in a sex- and country-specific context.