The purpose of this study was to examine the associations between serum
uric acid (SUA) levels and the incidences of
hypertension and
metabolic syndrome (MetS) in a large screened cohort of Japanese men and women. We evaluated 4812 subjects (males, 2528; females, 2284; mean age, 47.5 years) who underwent health checkups between 2006 and 2010 and were free of
hypertension and MetS in 2006. After 4 years, 618 (13%), 764 (16%) and 158 (3%) subjects developed
hypertension, MetS and
hypertension with MetS, respectively. Increased SUA levels were significantly and positively associated with the incidences of
hypertension, MetS and
hypertension with MetS. Compared with the first quartile of SUA levels, the odds ratios (95% confidence intervals) for the third and fourth quartiles, respectively, were as follows: 1.5 (1.1-2.1; P = 0.0128) and 1.8 (1.2-2.5; P = 0.0022) for
hypertension, 1.3 (0.9-1.9; P = 0.1910) and 1.8 (1.2-2.7; P = 0.0039) for MetS and 2.7 (1.1-6.6; P = 0.0276) and 3.2 (1.3-8.0; P = 0.0115) for
hypertension with MetS. In conclusion, increased SUA levels were significantly and independently associated with the incidences of
hypertension and MetS in subjects without
hypertension or MetS at baseline. Increased SUA levels might also be correlated with the incidence of
hypertension with MetS.