Abstract
There is an increasing prevalence of gout and hyperuricemia worldwide. Gout confers a significant individual and social burden and is increasingly recognized as a prevalent chronic disease state requiring appropriate long-term management. Gout and hyperuricemia appear to be independent risk factors for incident hypertension, renal disease and cardiovascular disease. Multiple epidemiologic studies confirm an association between hyperuricemia and “cardiometabolic disease”. We review the evidence stating the relationship between hyperuricemia and the development of comorbid conditions contributing to cardiovascular risk and disease.
Similar content being viewed by others
References
Richette P, Bardin T. Gout. Lancet 2010; 375 (9711):318–328.
Choi HK, Mount DB, Reginato AM. Pathogenesis of gout. Ann Intern Med. 2005;143:499–516.
Johnson RJ, Rideout BA. Uric acid and diet-insights into the epidemic of cardiovascular disease. N Engl J Med. 2004;350:1071–3.
Edwards NL. The role of hyperuricemia and gout in kidney and cardiovascular disease. Cleve Clin J Med. 2008;75(Suppl 5):S13–6.
Gustafsson D, Unwin R. The pathophysiology of hyperuricaemia and its possible relationship to cardiovascular disease, morbidity and mortality. BMC Nephrol. 2013;14:164.
Wortmann RL. Gout and hyperuricemia. Curr Opin Rheumatol. 2002;14:281–6.
Saag KG, Mikuls TR. Recent advances in the epidemiology of gout. Curr Rheumatol Rep. 2005;7:235–41.
Grassi D, Ferri L, Desideri G, Di Giosia P, Cheli P, Del Pinto R, Properzi G, Ferri C. Chronic hyperuricemia, uric acid deposit and cardiovascular risk. Curr Pharm Des. 2013;19(13):2432–8.
Johnson RJ, Kang DH, Feig D, Kivlighn S, Kanellis J, Watanabe S, Tuttle KR, Rodriguez-Iturbe B, Herrera-Acosta J, Mazzali M. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension. 2003;41:1183–90.
Yoo TW, Sung KC, Shin HS, et al. Relationship between serum uric acid concentration and insulin resistance and metabolic syndrome. Circ J. 2005;69:928–33.
Ferri C, Ferri L, Grassi D. Uric acid as a marker and contributor to cardiovascular disease. Cardiol Clin Pract. 2011;3(1):1–11.
Cannon PJ, Stason WB, Demartini FE, Sommers SC, Laragh JH. Hyperuricemia in primary and renal hypertension. N Engl J Med. 1966;275:457–64.
Perlstein TS, Gumieniak O, Williams GH, et al. Uric acid and the development of hypertension: the normative aging study. Hypertension. 2006;48(6):1031–6.
Messerli FH, Frohlich ED, Dreslinski GR, Suarez DH, Aristimuno GG. Serum uric acid in essential hypertension: an indicator of renal vascular involvement. Arch Intern Med. 1980;93:817–21.
Friedl HP, Smith DJ, Till GO, Thomson PD, Louis DS, Ward PA. Ischemia-reperfusion in humans. Appearance of xanthine oxidase activity. Am J Pathol. 1990;136(3):491–5.
Ferrannini E, Galvan AQ, Gastaldelli A, Camastra S, Sironi AM, Toschi E, Baldi S, Frascerra S, Monzani F, Antonelli A, Nannipieri M, Mari A, Seghieri G, Natali A. Insulin: new roles for an ancient hormone. Eur J Clin Investig. 1999;29(10):842–52.
Gonçalves JP, Oliveira A, Severo M, Santos AC, Lopes C. Cross-sectional and longitudinal associations between serum uric acid and metabolic syndrome. Endocrine. 2012;41(3):450–7.
Rodrigues SL, Baldo MP, Capingana P, Magalhães P, Dantas EM, Molina Mdel C, Salaroli LB, Morelato RL, Mill JG. Gender distribution of serum uric acid and cardiovascular risk factors: population based study. Arq Bras Cardiol. 2012;98(1):13–21.
Fam AG. Gout, diet, and the insulin resistance syndrome. J Rheumatol. 2002;29:1350–5.
Facchini F, Chen YD, Hollenbeck CB, Reaven GM. Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration. JAMA. 1991;266(21):3008–11.
Dessein PH, Shipton EA, Stanwix AE, Joffe BI, Ramokgadi J. Beneficial effects of weight loss associated with moderate calorie/ carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study. Ann Rheum Dis. 2000;59:539–43.
Cicero AF, Salvi P, D’Addato S, Rosticci M, Borghi C, Brisighella Heart Study group. Association between serum uric acid, hypertension, vascular stiffness and subclinical atherosclerosis: data from the Brisighella Heart Study. J Hypertens. 2014;32(1):57–64.
Liese AD, Hense HW, Lowel H, et al. Association of serum acid with all-cause and cardiovascular disease and incident myocardial infarction in the MONICA Augsburg cohort. World Health Organization monitoring trends and determinants in cardiovascular diseases. Epidemiology. 1999;10:391–7.
Hoieggen A, et al. The impact of serum uric acid on cardiovascular outcomes in the LIFE study. Kidney Int. 2004;65:1041–9.
Bos MJ, Koudstaal PJ, Hofman A, Witteman JCM, Breteker MMB. Uric acid is a risk factor for myocardial infarction and stroke. Stroke. 2006;37:1503–7.
Krishnan E, Baker JF, Furst DE, Schumacher HR. Gout and the risk of acute myocardial infarction. Arthritis Rheum. 2006;54:2688–96.
Brand FN, McGee DL, Kannel WB, Stokes J III, Castelli WP. Hyperuricemia as a risk factor of coronary heart disease: the Framingham Study. Am J Epidemiol. 1985;121:11–8.
Culleton BF, Larson MG, Kannel WB, Levy D. Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study. Ann Intern Med. 1999;131:7–13.
Strasak A, Ruttmann E, Brant L, et al. Serum uric acid and risk of cardiovascular mortality: a prospective long-term study of 83683 Austrian men. Clin Chem. 2008;54:273–84.
Loachimescu AG, Brennan DM, Hoar BM, Hazen SL, Hoogwerf BJ. Serum uric acid is an independent predictor of all-cause mortality in patients at high risk of cardiovascular disease: a preventive cardiology information system (PreCIS) database cohort study. Arthritis Rheum. 2008;58(2):623–30.
Verdecchia P, Schillaci G, Reboldi G, et al. Relation between serum uric acid and risk of cardiovascular disease in essential hypertension: the PIUMA study. Hypertension. 2000;36:1072–8.
Kim SY, Guevara JP, Kim KM, et al. Hyperuricemia and coronary heart disease: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2010;62(2):170–80.
Kim SY, Guevara JP, Kim KM, et al. Hyperuricemia and risk of stroke: a systematic review and meta-analysis. Arthritis Rheum. 2009;61(7):885–92.
Khosla UM, Zharikov S, Finch JL, et al. Hyperuricemia induces endothelial dysfunction. Kidney Int. 2005;67(5):1739–42.
Kanellis J, Kang DH. Uric acid as a mediator of endothelial dysfunction, inflammation, and vascular disease. Semin Nephrol. 2005;25(1):39–42.
Coronel F, Garcıa-Menal M, Herrero JA, et al. Irbesartan in hypertensive non-diabetic advanced chronic kidney disease: comparative study with ACEI. Nefrologia. 2008;28(1):56–60.
Becker MA, Schumacher HR, MacDonald PA, et al. Clinical efficacy and safety of successful longterm urate lowering with febuxostat or allopurinol in subjects with gout. J Rheumatol. 2009;36(6):1273–82.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Grassi, D., Desideri, G., Di Giacomantonio, A.V. et al. Hyperuricemia and cardiovascular risk. High Blood Press Cardiovasc Prev 21, 235–242 (2014). https://doi.org/10.1007/s40292-014-0046-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40292-014-0046-3