Serum uric acid and the risk of cardiovascular and renal disease

Abstract

Substantial evidence suggests that chronic hyperuricemia is an independent risk factor for hypertension, metabolic syndrome, chronic kidney disease (CKD) and cardiovascular diseases. This highlights the need for greater attention to serum uric acid levels when profiling patients, and suggests that the threshold above which uricemia is considered abnormal is 6 mg/dl, in light of the available evidence. Another important question is whether lowering serum uric acid can improve cardiovascular and renal outcomes, and what therapeutic mechanism of action could provide more clinical benefits to patients; the available literature shows a trend toward improvement associated with administration of urate-lowering drugs, in particular for the xanthine oxidase inhibitors. The demonstrated efficacy of urate-lowering therapy on outcomes other than gout flares leads to the consideration that treatment may be beneficial even in the absence of overt gout when hyperuricemia accompanies other clinical conditions, such as urate deposition, advanced CKD or cardiovascular risk factors.

The role of uric acid in metabolic syndrome in patients with psoriasis

“…Psoriazisdeki artmış enflamasyonun epitelyal disfonksiyona neden olduğu ve buna bağlı olarak kardiyovasküler hastalık riskinde artışa neden olduğu düşünülmektedir 2,[14][15][16] . Ürik asit hipertansiyon, metabolik sendrom ve aterosklerotik kalp hastalıkları gibi birçok durum ile ilişkili olduğu gösterilen metabolik bir belirteçtir [6][7][8] . Ürik asit ile metabolik sendrom ve komponentleri…”

“…Hatta yeni çalışmalarda psoriaziste sistemik bir enflamasyonun geliştiği ve buna bağlı olarak psoriazisin metabolik sendrom ile kardiyovasküler hastalıklarla ilişkili olduğu gösterilmiştir [2][3][4][5] . Önemi son yıllarda daha iyi anlaşılmış metabolik bir marker olan ürik asitin metabolik sendrom, hipertansiyon ve kardiyovasküler hastalıklarla ilişkili olduğu düşünülmektedir [6][7][8][9] . Psoriazis hastalarında ürik asit yüksekliği eskiden beri üzerinde çalışılan ve iyi bilinen bir durumdur 10,11 .…”

The challenge of Mendelian randomization approach

“…Hyperuricemia was associated with deleterious effects on endothelial dysfunction, oxidative metabolism, platelet adhesiveness, hemorheology, and aggregation 2,3 . A pathogenetic role of hyperuricemia in the progression of renal disease has been proposed based of mechanisms activated by high levels of uric acid, mainly at the vascular level 4 .…”

Effects of serum uric acid on blood-pressure lowering treatment

“…Serum uric acid (SUA) level has been shown to be associated with an increased risk of cardiovascular morbidity and mortality 1 , and it was found to be correlated with hypertension in children and adults 2,3 . The role of uric acid in blood-pressure (BP) control has been investigated to understand whether hyperuricemia is an independent risk factor, so that a urate lowering therapy should be used to reduce cardiovascular risk, or whether it represents a marker of other prognostic abnormalities.…”

“…The role of uric acid in blood-pressure (BP) control has been investigated to understand whether hyperuricemia is an independent risk factor, so that a urate lowering therapy should be used to reduce cardiovascular risk, or whether it represents a marker of other prognostic abnormalities. It has also been observed that urate lowering drugs may have an antihypertensive effect 1 . This article will briefly review the evidence of the link between hypertension and SUA and will discuss the impact of uric acid on BP lowering therapy.…”