6%. It was very similar to that in the urban areas of northeastern China,16 and significantly higher than that reported at the beginning of this century for the entire country.3 Further analysis showed that increased BMI was the most important risk factor for prehypertension in our study. Even among patients with low-range prehypertension,

BMI was significantly increased compared VE-822? with the optimal BP group. Therefore, our study suggests that although sodium intake is relatively low in the Guangdong Province in southern China,17 the prevalence of prehypertension is almost as high as that in the northern area. With the economic development and lifestyle changes, obesity/overweight has become a very important risk factor for increased BP. Although the proportions of IFG and dyslipidaemia were higher in the prehypertension group than in the optimal BP group, in multivariable analysis the associations of IFG and dyslipidaemia with prehypertension were not significant after adjustment for BMI. Many studies have documented that overweight/obesity can cause significant insulin resistance, which may play

an important role in impaired glucose metabolism, dyslipidaemia and increased BP.18 19 Clinical studies have shown that weight control can significantly lower BP.20 These results indicated that lifestyle modifications, such as weight loss, are effective in the long-term primary prevention of hypertension. With the economic development and lifestyle changes, lifestyle modifications should be emphasised as a cornerstone in modern China. In addition to the traditional risk factors, previous studies have found that serum UA levels were significantly associated with prehypertension.21 22 The mechanisms may be associated with inhibition of the nitric oxide pathway and activation of the renin-angiotensin system.

Further, UA can cause a proliferation of vascular smooth muscle cells and renal microvascular damage because of local inflammation and oxidative stress, finally leading to high BP.23 24 In our study, we found that the level of UA tended to increase in the low-range prehypertension group (p=0.07), and the difference was significant between high-range prehypertension and the optimal BP groups. These results indicate that the effect of UA on BP may be increased Dacomitinib throughout the entire prehypertension range. In a recent randomised controlled trial, prehypertensive obese adolescents aged 11–17 years were enrolled and randomised to a urate-lowering therapy (including allopurinol or probenecid) or placebo. Participants treated with a urate-lowering therapy experienced a highly significant reduction in BP (SBP 10.2 mm Hg and DBP 9.0 mm Hg, respectively). Systemic vascular resistance was also reduced in the urate-lowering therapy group.25 These findings strongly supported the synergistic pathogenic role of UA and obesity in hypertension.