OP0208 EFFECT OF SERUM URATE LOWERING WITH ALLOPURINOL ON BLOOD PRESSURE IN YOUNG ADULTS

Background The association between serum urate and hypertension continues to be controversial. Animal models and studies in adolescents provided strong support of urate- lowering therapy (ULT) efficacy to improve early hypertension (1), while one recent randomized-controlled study in adults failed to find benefit (2). Objectives To test the hypothesis that serum urate reduction with allopurinol would lead to blood pressure reductions in young adults with pre-hypertension. Methods Single center, double-blinded, crossover trial in which participants were randomly assigned to allopurinol (300 daily mg) or placebo for a period of one month each. Adults ages 18-40, with baseline systolic blood pressure (SBP) ≥ 120 and 297.4 µmol/L) or ≥ 4.0 mg/dL (237.9 µmol/L) (men or women, respectively) were enrolled. Main exclusion criteria included chronic kidney disease, gout, or use of ULTs. The primary outcome was change from baseline in SBP assessed by 24 hour ambulatory blood pressure monitoring. Safety assessments were also conducted. Results 99 participants were randomized, and 82 completed study participation (Table 1). Serum urate decreased by -1.33 ± 1.21 mg/dL (-79.1 ± 72.0 µmol/L) during the allopurinol period (p 6.5 mg/dL (> 386.7 µmol/L) at baseline visit. No allopurinol hypersensitivity events or other serious adverse events were observed. Conclusion In the intention-to-treat analysis, urate -lowering therapy with allopurinol in young adults did not lead to reductions in blood pressure when compared with placebo. Blood pressure reductions with allopurinol may be limited only to participants with higher baseline serum urate levels. References [1] Feig DI, Soletsky B, Johnson RJ. JAMA. 2008;300:924-32. [2] McMullan CJ, Borgi L, Fisher N, et al. Clin J Am Soc Nephrol. 2017;12:807-16. Disclosure of Interests Angelo Gaffo: None declared, David Calhoun: None declared, Elizabeth Rahn: None declared, Suzanne Oparil: None declared, Paul Muntner Grant/research support from: Dr. Muntner declares research grant from Amgen, Peng Li: None declared, David Redden: None declared, Tanja Dudenbostel: None declared, Jeff Foster: None declared, Stephanie Biggers: None declared, Daniel Feig: None declared, Kenneth Saag Grant/research support from: Amgen, Ironwood/AstraZeneca, Horizon, SOBI, Takeda, Consultant for: Abbvie, Amgen, Ironwood/AstraZeneca, Bayer, Gilead, Horizon, Kowa, Radius, Roche/Genentech, SOBI, Takeda, Teijin