Background/Purpose: Serum urate (sUA) has been associated with blood pressure in most but not all studies. This study aims to test whether there are sex differences in the association between sUA and systolic blood pressure (SBP) in young adults.

Methods: This is a cross sectional analysis using baseline data from young adults with normal renal function participating in a clinical trial. Men and women ages 18-40 years were eligible if they had SBP ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg and sUA > 5.0 mg/dL for men and >4.0 mg/dL for women.  Multiple linear regression analysis was used to evaluate the association between sUA and SBP (measured with in-office sphygmomanometer), controlling for age, sex and race. The potential sex difference was tested with a sex-by-sUA interaction term in the regression model.

Results: The mean age of the 99 participants was 27.6±6.9 years; 37.4% were female, and 40.4% were African American. After controlling for age, sex and race, SBP was significantly associated with sUA (p=0.019). The results also suggested a statistically significant sex difference in the association (p=0.026). Specifically, a one unit increase in sUA was associated with 6.8 mm Hg higher SBP in women, but only 0.2 mm Hg in men (Figure). No statistically significant race effect was detected.

Conclusion: Higher sUA was associated with higher SBP in women but not in men. This association was present at ranges of sUA below the threshold of hyperuricemia (6.8 mg/dL). Whether an interaction between sUA and hormonal factors can account for this differential effect of sex on SBP in young adults should be explored further.