Beyond gout: uric acid and cardiovascular diseases

Abstract

Objectives:

This article discusses the results of clinical and experimental studies that examine the association of hyperuricemia and gout with cardiovascular (CV) disease.

Methods:

Key papers for inclusion were identified by a PubMed search, and articles were selected for their relevance to the topic, according to the authors’ judgment.

Results and conclusions:

Significant progress has been made in confirming an association, possibly causal, between hyperuricemia and CV outcomes. Xantine-oxidase (XO) inhibitors appear to be the most promising agents for prevention and treatment of CV consequences associated with hyperuricemia. Several small and medium sized studies have examined the effect of these agents on CV function in a variety of patient populations. Improvements in measures of endothelial function, oxidative stress, cardiac function, hemodynamics, and certain inflammatory indices have been demonstrated. Compounds for XO inhibition with more specific clinical effects and fewer side effects than allopurinol may be promising options to further explore the therapeutic potential in patients with CV disease. It is too early to make clinical recommendations with regard to the benefits of using XO inhibitor allopurinol or the novel febuxostat in patients with asymptomatic increased UA levels and high CV risk because only a small number of studies have shown that they may be beneficial in terms of CV outcomes. More studies are therefore needed to determine the potential of these drugs for reducing the risk of developing CV disease.

Keywords::

• Cardiovascular disease
• Gout
• Hyperuricemia
• Xanthine oxidase inhibitor

Transparency

Declaration of funding

Menarini International provided funding for editorial assistance.

Declaration of financial/other relationships

G.G. has declared that he is a consultant to Menarini, Astra Zeneca, Medtronic and Guidotti. E.A.-R. has disclosed that he has no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers on this manuscript have received honoraria for their review work, but have no other relevant financial relationships to disclose.

Acknowledgments

Editorial assistance for the preparation of this manuscript was provided by Luca Giacomelli PhD on behalf of Content Ed Net.