Changes in serum uric acid levels and cardiovascular events: A meta-analysis

Relation of Serum Uric Acid Levels and Outcomes Among Patients Hospitalized for Worsening Heart Failure With Reduced Ejection Fraction (from the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan Trial)

“…28 A recent meta-analysis of 11 trials and over 20,000 subjects followed for 2 years showed that sUA changes during pharmacologic treatment did not predict cardiovascular outcomes. 29 We await the results of the recently completed EXACT-HF (Xanthine Oxidase Inhibition for Hyperuricemic Heart Failure Patients; NCT00987415) trial, which is a multicenter randomized 24-week trial of allopurinol in hyperuricemic (sUA !9.5 mg/dl) patients with chronic HF with reduced EF. 30 The post hoc nature of the present study makes the findings vulnerable to selection bias and confounding from measured and unmeasured parameters.…”

Serum uric acid and incident osteoporotic fractures in old people: The PRO.V.A study

“…Hyperuricemia is significantly 52 associated with obesity, hypertension, dyslipidemia, diabetes and met-53 abolic syndrome, which could increase the risk of developing several 54 conditions, e.g. disability, mortality, osteoporosis and fractures [1][2][3]. 55 Since the risk of monosodium urate (MSU) crystal formation increases 56 linearly with aging, it is hardly surprising that hyperuricemia is a 57 more important risk factor for disability and mortality in older people 58 than in the middle-aged [4].…”

Review of Hyperuricaemia and Hypertension: A Target for Treatment

“…The authors concluded that elevated serum urate does not have a causal role in the development of coronary heart disease, death from cardiovascular disease, or death from all causes [58]. A meta-analysis of 11 trials involving 21,373 participants looking at changes in serum urate and cardiovascular events found that there was no relationship between changes in urate levels and outcomes [59]. The authors acknowledged that hyperuricaemic patients are at increased risk of cardiovascular events however as many of the risk factors for hyperuricaemia are the same risk factors as for cardiovascular disease the difficulty remains in separating out the individual effect of hyperuricaemia [59][60][61].…”

“…A meta-analysis of 11 trials involving 21,373 participants looking at changes in serum urate and cardiovascular events found that there was no relationship between changes in urate levels and outcomes [59]. The authors acknowledged that hyperuricaemic patients are at increased risk of cardiovascular events however as many of the risk factors for hyperuricaemia are the same risk factors as for cardiovascular disease the difficulty remains in separating out the individual effect of hyperuricaemia [59][60][61]. This also confirms the ongoing doubt surrounding the best management of hyperuricaemia as evidence that aggressive treatment of hyperuricaemia improves overall cardiovascular outcomes is lacking.…”