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Published on: November 7, 2017
Uric acid and heart failure
Masanari Kuwabara1, Arrigo F G Cicero2, Naoyuki Akashi3
1Division of Public Health, Center for Community Medicine, Jichi Medical University, Tochigi, Japan; Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University Tochigi, Japan.
Journal of Cardiology
|July 21, 2026
Summary
Hyperuricemia, or high uric acid levels, is a growing concern in heart failure patients. While evidence is limited, uric acid-lowering agents may be considered, with some studies suggesting potential benefits for heart failure management.
Area of Science:
- Cardiology
- Nephrology
- Metabolic Disorders
Background:
- Increasing global prevalence of heart failure and hyperuricemia.
- Hyperuricemia as a negative prognostic indicator in heart failure patients.
- Lack of consensus on the therapeutic benefits of treating hyperuricemia in heart failure.
Purpose of the Study:
- To review current clinical trials on hyperuricemia in heart failure.
- To evaluate the efficacy of uric acid-lowering agents in improving symptoms and prognosis.
- To explore the role of serum uric acid as a biomarker and potential therapeutic target.
Main Methods:
- Review of existing clinical trials and cohort studies.
- Analysis of Medicare data from approximately 100,000 participants.
- Examination of evidence on uric acid-lowering agents like febuxostat and allopurinol.
Main Results:
- Febuxostat showed less heart failure aggravation compared to allopurinol in a large US cohort.
- Serum uric acid may indicate disease severity, oxidative stress, and xanthine oxidase activity.
- Differential effects of uric acid-lowering agents suggest drug-specific cardiovascular impacts.
Conclusions:
- Further large-scale prospective studies are needed to confirm the efficacy of treating hyperuricemia in heart failure.
- Uric acid-lowering agents can be a treatment option if lifestyle changes fail to lower serum uric acid below 8 mg/dL.
- Targeting xanthine oxidase and oxidative stress may benefit specific heart failure subgroups.
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