Uric acid is independent cardiovascular risk factor, as manifested by increased carotid intima-media thickness in rheumatoid arthritis patients
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Updated: Feb 27, 2026

Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Suad Hannawi1, Issa AlSalmi2, Ingrid Moller3
1Ministry of Health and Prevention, P.O.Box 65522, Dubai, United Arab Emirates. suad1@ausdoctors.net.
Insights
Serum uric acid (SUA) is a cardiovascular risk factor in rheumatoid arthritis (RA) patients, indicated by increased carotid intima-media thickness (cIMT). This finding highlights SUA
Area of Science:
- Cardiology
- Rheumatology
- Vascular Biology
Background:
- Rheumatoid arthritis (RA) significantly increases cardiovascular disease (CVD) risk.
- Non-traditional cardiovascular risk factors, including serum uric acid (SUA), contribute to CVD in RA.
- Subclinical atherosclerosis, measured by carotid intima-media thickness (cIMT), is a key indicator of cardiovascular risk.
Purpose of the Study:
- To investigate the role of SUA as a cardiovascular risk factor in RA patients.
- To correlate SUA levels with traditional cardiovascular risk factors and inflammation markers.
- To determine the association between SUA and subclinical atherosclerosis (cIMT) in RA.
Main Methods:
- Cross-sectional study of 53 RA patients without clinically evident CV or renal disease.
- Assessment of cIMT using ultrasound (US).
- Measurement of SUA, traditional cardiovascular risk factors, and inflammatory markers; correlation analysis performed.
Main Results:
- Univariate analysis revealed positive correlations between cIMT and age, age at RA onset/diagnosis, smoking, blood pressure, and SUA.
- Rheumatoid factor positivity and level were associated with increased cIMT.
- Multivariate analysis confirmed SUA as a significant independent predictor of cIMT, along with age, LDL, and triglycerides.
Conclusions:
- Serum uric acid (SUA) is identified as a significant cardiovascular risk factor in rheumatoid arthritis (RA).
- Elevated SUA levels are associated with subclinical atherosclerosis (increased cIMT) in RA patients.
- SUA should be considered in cardiovascular risk assessment and management strategies for RA patients.
Abstract:
Rheumatoid arthritis (RA) is associated with increased cardiovascular disease (CVD) mortality and morbidity, due to the combined effects of traditional and non-traditional cardiovascular risk factors (CV). A serum uric acid (SUA) level has been suggested as one of the non-traditional cardiovascular risk factors. Cardiovascular risk can be assessed by looking at the subclinical atherosclerosis such as ultrasound (US)-measured carotid intima-media thickness (cIMT). This paper aimed to determine the role of SUA as a cardiovascular risk factor, along with the traditional cardiovascular risk factors and inflammation, among RA population. RA patients with no clinically evident CV or renal disease were studied. cIMT US, SUA, traditional cardiovascular, and inflammatory markers were obtained and correlated with cIMT. Among 53 RA patients (5 males, 48 females, mean age 48 ± 14 years), univariate linear-regression showed a positive linear relationship between cIMT and age (p < 0.001), age at RA symptoms onset and diagnosis (p = 0.010 and 0.003, respectively), number of cigarettes/day (p < 0.001), systolic and diastolic blood pressure (p = 0.005 and 0.030, respectively), and SUA (p = 0.007). Rheumatoid factor positivity and level were associated with thicker cIMT (p = 0.042 and 0.039, respectively). SUA maintained a significant correlation with cIMT in the multivariate analysis together with age, low-density lipoprotein, and triglyceride level. The model explained 55% (R2 55) of the causes of thick cIMT among RA population. SUA seems to be a cardiovascular risk factor in RA, as manifested by increase in the cIMT.
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