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Gout, hyperuricemia, and the risk of cardiovascular disease: cause and effect?

Ankoor Shah1, Robert T Keenan

  • 1Division of Rheumatology and Immunology, Duke University School of Medicine, 301 Trent Drive, Durham, NC 27710, USA.

Current Rheumatology Reports
|April 29, 2010
PubMed

Insights

Gout and hyperuricemia may impact cardiovascular disease risk. Research explores whether elevated uric acid independently contributes to heart conditions or merely indicates other risk factors.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Rheumatology

Background:

  • Gout and hyperuricemia are suspected cardiovascular disease (CVD) risk factors.
  • Uncertainty exists whether they are independent factors or markers for other risks.
  • Uric acid's role is complex, with potential pro-inflammatory and antioxidant effects.

Purpose of the Study:

  • To review evidence on the independent role of hyperuricemia and gout in cardiovascular pathology.
  • To clarify the association between elevated serum uric acid and CVD.

Main Methods:

  • Review of in vitro, animal, and large clinical trial data.
  • Analysis of studies investigating uric acid's biological activity.
  • Evaluation of epidemiological associations between serum uric acid and CVD.

Main Results:

  • In vitro and animal studies suggest uric acid can promote vascular damage via inflammation.
  • Uric acid exhibits antioxidant properties, potentially protective.
  • Clinical trials show a consistent, though variable, association between high serum uric acid and CVD.

Conclusions:

  • The independent contribution of hyperuricemia and gout to cardiovascular pathology requires further elucidation.
  • Uric acid's dual role as pro-inflammatory and antioxidant complicates its direct link to CVD.
  • Continued research is necessary to understand the precise relationship between uric acid levels and cardiovascular risk.

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