Gout, Hyperuricemia, and the Risk of Cardiovascular Disease: Cause and Effect?

Abstract

Gout and hyperuricemia have long been suspected to be risk factors for cardiovascular disease. However, studies have frequently failed to distinguish whether these entities have an independent effect on cardiovascular risk or serve as markers for other risk factors. In vitro and animal studies suggest that uric acid is a biologically active compound that can increase inflammatory mediators known to lead to vascular damage. In contrast, uric acid also has potentially protective effects as a strong antioxidant, approaching the potency of vitamin C. Large clinical trials demonstrate a consistent relationship between elevated serum uric acid and a variety of cardiovascular diseases, although the strength of association varies greatly. We review the evidence for and against an independent role for hyperuricemia and/or gout in cardiovascular pathology.

Patients with gout have short telomeres compared with healthy participants: association of telomere length with flare frequency and cardiovascular disease in gout

“…Gout is often accompanied by cardiovascular comorbid conditions including myocardial infarction (MI) and cerebrovascular events, which lead to an increased morbidity and decreased life span 14 15. Gout is also associated with metabolic syndrome, diabetes and renal failure, which in turn are predictors for cardiovascular disease.…”

Evaluation of Oxidative Status of Patients with Gout Attack in a Cameroonian Urban Hospital

“…Oxidative stress is an imbalance between the oxidant and antioxidant factors of the body in favour of the oxidizing factors with formation of free radicals and other active oxygenated species; these free radicals will be responsible for the cellular damage, leading to aging, increasing cardiovascular risk and promoting many ailments [9]. Uric acid has been described in several studies in Caucasian and Indonesian populations as having an antioxidant but also a pro-oxidant effect [8] [10] [11]. The relationship between hyperuricemia, gout and oxidative stress is therefore not clearly established, so it appears important to evaluate the oxidative status of subjects with gout in order to contribute to the improvement of knowledge on the issue.…”

Canakinumab for acute gouty arthritis in patients with limited treatment options: results from two randomised, multicentre, active-controlled, double-blind trials and their initial extensions

“…Consequently, these patients can develop frequent flares and persistent inflammation between flares,13 which may contribute to joint destruction and may impact health-related quality of life 14 15. In addition, uncontrolled gouty arthritis and hyperuricaemia may exacerbate comorbidities 16 17. Therefore, effective alternative treatments for flares are needed in this patient population.…”