Uric acid-lowering therapy with benzbromarone in hypertension with asymptomatic hyperuricemia: a randomized study focusing left ventricular diastolic function

Abstract

Background

Both hypertension and hyperuricemia are closely associated with the morbidity and mortality of heart failure with preserved ejection fraction (HFpEF). However, there is limited evidence on the effect of uric acid-lowering therapy on left ventricular (LV) diastolic function in this population. In this randomized study, we prescribed benzbromarone, a uric acid-lowering drug, to those with hypertension and asymptomatic hyperuricemia to investigate its clinical benefits by evaluating LV diastolic function, incidence of HFpEF and hospitalization for heart failure and cardiovascular death.

Methods

230 participants were randomly assigned into two groups: uric acid-lowering group (benzbromarone) and control groups (without uric acid-lowering drug). The primary endpoint was LV diastolic function evaluated by echocardiography. The secondary endpoint of composite endpoints is the combination of new-onset HFpEF, hospitalization for heart failure and cardiovascular death.

Results

After a median of 23.5 months’ follow-up (16–30 months), the primary endpoint reflected by E/e’ in benzbromarone group reached a significant improvement when compared to control group (p <.001). Composite endpoints occurred in 11 patients of the control group while only 3 patients occurred in the benzbromarone group (p = .027). We also presented the favorable trend of freedom from the composite endpoints or new-onset HFpEF using Kaplan–Meier curve by log-rank test in benzbromarone group (p = .037 and p = .054).

Conclusions

Our study demonstrated the efficiency of benzbromarone in hypertensive patients with concomitant asymptomatic hyperuricemia, including the benefits on ameliorating LV diastolic dysfunction as well as improving composite endpoints.

Keywords:

• Hypertension
• asymptomatic hyperuricemia
• benzbromarone
• left ventricular diastolic function

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Jiahan Ke wrote the manuscript, Jianan Pan and Hao Lin analyzed the data, Zhihua Han and Jun Gu conducted the investigation. There’s no conflict of interest.

Acknowledgements

None.

Data availability statement

The data that support the finding of this study are available from the corresponding author upon reasonable request. The data are not publicly available due to privacy and ethical restriction.

Ethics

Informed consent was obtained from all individual participants included in the study.

Trial Registration

This study was performed in line with the principles of the Declaration of Helsinki and it has been registered at the Chinese Clinical Trial Register (Registration number: ChiCTR1900023033)

Additional information

Funding

This study was supported by the Clinical Research Program [JYLJ201803, JYLJ202209] of Shanghai Ninth People’s Hospital, Biobank for Coronary Heart Disease [YBKA201910] of Shanghai Ninth People’s Hospital, Research Projects from the Natural Science Foundation of Shanghai [20ZR1431100, 23ZR1437200] and Project from Shanghai Health Commission [202240149].