How could sugar-sweetened beverages cause blood pressure elevation?

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In recent national surveys, the average blood pressure and the prevalence of elevated blood pressure have been increasing in children and adolescents. Analyses have shown that some, but not all, of the increase can be attributed to the trends of increasing obesity. This raises the question concerning what other factors might be responsible for these trends.

In this issue of The Journal, Nguyen et al evaluated the relationship of sugar-sweetened beverages with serum uric acid levels and blood pressure in adolescents. The rationale for examining this is that many beverages are sweetened with high fructose corn syrup. Fructose is metabolized in the liver, where it induces nucleotide catabolism, which produces uric acid. They found that with increased intake of sugar-sweetened beverages both serum uric acid and systolic blood pressure z-score increased, after controlling for potential cofounders, such as BMI z-score.

In an accompanying editorial, Feig indicates that the mechanisms involved with blood pressure elevation may be complex, as uric acid has effects on endothelial cells, vascular smooth muscle cells, and adipocytes, all of which could be implicated in blood pressure elevation. These results from Nguyen et al could suggest pathways other than obesity through which sugar-sweetened beverages and other sweets could have an impact on blood pressure in young individuals.

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