Atherosclerosis
Volume 202, Issue 1 , Pages 11-17 , January 2009

Uric acid: A marker of increased cardiovascular risk

  • Ana C.M. Gagliardi
  • ,
  • Marcio H. Miname
  • ,
  • Raul D. Santos

      Affiliations

    • Corresponding Author InformationCorresponding author at: Unidade Clínica de Lípides InCor - HC.FMUSP Av. Dr Éneas de Carvalho Aguiar, 44, 2° andar, bloco 2, sala 4, Sao Paulo, SP, Brazil. Tel.: +55 11 30695320; fax: +55 11 30695320.

Received 6 February 2008 ,Revised 8 May 2008 ,Accepted 13 May 2008.

References 

  1. Wu XM, Muzny DM, Lee CC, Caskey CT. Two independent mutational events in the loss of urate oxidase during hominoid evolution. J Mol Evol. 1992;34:78–84
  2. Mohamed F. On chronic Bright's disease, and essential symptoms. Lancet. 1879;1:399–401
  3. Culleton BF, Larson MG, Kannel WB, Levy D. Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study. Ann Intern Med. 1999;131:7–13
  4. Choi HK, Atkinson K, Karlson EW, Curhan G. Obesity, weight change, hypertension, diuretic use and risk of gout in men: the Health Professionals Follow-Up Study. Arch Intern Med. 2005;165:742–748
  5. Johnson RJ, Feig DI, Herrera-Acosta J, Kang DH. Resurrection of uric acid as a causal risk factor in essential hypertension. Hypertension. 2005;45:18–20
  6. Coutinho TA, Turner ST, Peyser PA, et al. Associations of serum uric acid with markers of inflammation, metabolic syndrome and subclinical coronary atherosclerosis. Am J Hypertens. 2007;20:83–89
  7. Ioachimescu AG, Brennan DM, Hoar BM, Hazen SL, Hoogwerf BJ. Serum uric acid is an independent predictor of all-cause mortality in patients at high risk of cardiovascular disease. A preventive cardiology information system (PreCIS) database cohort study. Arthritis Rheum. 2008;58:623–630
  8. Alderman MH, Cohen H, Madhavan S, Kivlighn S. Serum uric acid and cardiovascular events in successfully treated hypertensive patients. Hypertension. 1999;34:144–150
  9. Liese AD, Hense HW, Löwel H, et al. Association of serum acid with all-cause and cardiovascular disease and incident myocardial infarction in the MONICA Augsburg cohort. World Health Organization monitoring trends and determinants in cardiovascular diseases. Epidemiology. 1999;10:391–397
  10. Bos MJ, Koudstaal PJ, Hofman A, Witteman JCM, Breteker MMB. Uric acid is a risk factor for myocardial infarction and stroke. Stroke. 2006;37:1503–1507
  11. Moriarity JT, Folsom AR, Iribarren C, Nieto FJ, Rosamond WD. Serum acid uric and risk of coronary heart disease: Atherosclerosis Risk in Communities (ARIC) study. Ann Epidemiol. 2000;10:136–143
  12. Hozawa A, Folsom AR, Ibrahim H, et al. Serum uric acid and risk of ischemic stroke: the ARIC study. Atherosclerosis. 2006;187:401–407
  13. Niskanen LK, Laaksonen DE, Nyyssönen K, et al. Uric acid level as a risk factor for cardiovascular and all-cause morality in middle-aged men: a prospective cohort study. Arch Intern Med. 2004;16:1546–1551
  14. Krishnan E, Baker JF, Furst DE, Schumacher HR. Gout and the risk of acute myocardial infarction. Arthritis Rheum. 2006;54:2688–2696
  15. Grundy SM, et al. Diagnosis and management of metabolic syndrome: an American Heart Association/National Heart, Lung and Blood Institute Scientific Statement. Circulation. 2005;112:2735–2752
  16. Schmidt MI, Duncan BB, Watson RL, et al. A metabolic syndrome in whites and Áfrican-Americans. The atherosclerosis risk in communities baselines study. Diabetes Care. 1996;19:414–418
  17. Yoo TW, Sung KC, Shin HS, et al. Relationship between serum uric acid concentration and insulin resistance and metabolic syndrome. Circ J. 2005;69:928–933
  18. Onat A, Uyarel H, Hergenc G, et al. Serum uric acid is a determinant of metabolic syndrome in a population-based study. Am J Hypertens. 2006;19:1055–1062
  19. Tuttle KR, Short RA, Johnson RJ. Sex differences in uric acid and risk factors for coronary artery disease. Am J Cardiol. 2001;87:1411–1414
  20. Chien KL, Hsu HC, Sung FC, Chen MF, Lee YT. Hyperuricemia as risk factor on cardiovascular events in Taiwan: the Chin-Shan Community Cardiovascular Cohort study. Atherosclerosis. 2005;183:147–155
  21. Takahashi S, Yamamoto T, Tsutsuni Z, et al. Close correlation between visceral fat accumulation and uric acid metabolism in healthy men. Metabolism. 1997;46:1162–1165
  22. Ishizaka N, Ishizaka Y, Ei-Ichi T, Nagai R, Yamakado M. Association between serum uric acid, metabolic syndrome, and carotid atherosclerosis in Japanese individuals. Arterioscler Thromb Vasc Biol. 2005;25:1038–1044
  23. Galvan AQ, Natali A, Baldi S, et al. Effect of insulin on uric acid excretion in humans. Am J Physiol. 1995;268:E1–E5
  24. Facchini F, Chen YD, Hollenbeck CB, Reaven GM. Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration. JAMA. 1991;26:1514–1520
  25. Lin KC, Tsao HM, Chen CH, Chou P. Hypertension was the major risk factor leading to development of cardiovascular diseases among men with hyperuricemia. J Rheumatol. 2004;31:1152–1158
  26. Verdecchia P, Schillaci G, Reboldi G, et al. Relation between serum uric acid and risk of cardiovascular disease in essential hypertension: the PIUMA study. Hypertension. 2000;36:1072–1078
  27. Sundström J, Sullivan L, D’Agostino R, et al. Relations of serum uric acid to longitudinal blood pressure tracking and hypertension incidence in the Framingham Heart Study. Hypertension. 2005;45:28–33
  28. Go AS, Chertow GM, Fan D, et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296–1305
  29. Johnson RJ, Kang DH, Feig D, et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease?. Hypertension. 2003;416:1183–1190
  30. Giacomello A, Di Sciascio N, Quaratino CP. Relation between serum triglyceride level, serum urate concentration, and fractional urate excretion. Metabolism. 1997;46:1085–1089
  31. Rathman W, Funkhouser E, Dyer AR, Roseman JM. Relations of hyperuricemia with the various components of the insulin resistance syndrome in young black and white adults: the CARDIA study. Coronary Artery Risk Development in Young Adults. Ann Epidemiol. 1998;8:250–261
  32. Desai MY, Dalal D, Santos RD, et al. Association of body mass index, metabolic syndrome, and leukocyte count. Am J Cardiol. 2005;97:835–838
  33. Sekby JV, Friedman GD, Quesenberry CP. Precursors of essential hypertension: pulmonary function, heart rate, uric acid, serum cholesterol, and other serum chemistries. Am J Epidemiol. 1990;131:1017–1027
  34. Vourinen-Markkola H, Yki-Jarvinen H. Hyperuricemia and insulin resistance. J Clin Endocrinol Metab. 1994;78:25–29
  35. Lee J, Sparrow D, Vokonas PS, Landsberg L, Weiss ST. Uric acid and coronary heart disease risk: evidence for a role of uric acid in the obesity-insulin resistance syndrome. The Normative Aging Study. Am J Epidemiol. 1995;142:288–294
  36. McLaughlin T, Abbasi F, Cheal K, et al. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med. 2003;139:802–809
  37. Jeppesen J, Hein HO, Suadicani P, Gyntelberg F. Low triglycerides-high high-density lipoprotein cholesterol and risk of ischemic heart disease. Arch Intern Med. 2001;161:361–366
  38. Messerli FH, Fröhlich ch ED, Dreslinski GR, Suarez DH, aristimuno GG. Serum uric acid in essential hypertension: an indicator of renal vascular involvement. Ann Intern Med. 1980;93:817–821
  39. Nieto FJ, Iribarren C, Gross MD, Cosmotock GW, Cutler RG. Uric acid and serum antioxidant capacity: a reaction to atherosclerosis?. Atherosclerosis. 2000;148:131–139
  40. Tsouli SG, Liberopoulos EN, Mikhailidis DP, Athyros VG, Elisaf MS. Elevated serum acid levels in metabolic syndrome: an active component or an innocent bystander?. Metab Clin Exp. 2006;55:1293–1301
  41. Ruggiero C, Cherubini A, Ble A, et al. Uric acid and inflammatory markers. Eur Heart J. 2006;27:1174–1181
  42. Fröhlich ch M, Imhof A, Berg G, et al. Association between C-reactive protein and features of the metabolic syndrome: a population-based study. Diabetes Care. 2000;23:1835–1839
  43. Ruggiero C, Cherubini A, Miller E, et al. Usefulness of uric acid to predict changes in C-reactive protein and interleukin-6 in 3-year period in Italians aged 21 to 98 years. Am J Cardiol. 2007;100:115–121
  44. Leyva F, Anker SD, Godsland IF, et al. Uric acid in chronic heart failure: a marker of chronic inflammation. Eur Heart J. 1998;19:1814–1822
  45. Zweier JL, Kuppusamy P, Lutty GA. Measurement of endothelial cell free radical generation: evidence for a central mechanism of free radical injury in postischemic tissues. Proc Natl Acad Sci USA. 1988;85:4046–4050
  46. Khosla UM, Zharikov S, Finch JL, et al. Hyperuricemia induces endothelial dysfunction and vasoconstriction. Kidney Int. 2005;67:1739–1742
  47. Feig DI, Johnson RJ. Hyperuricemia in childhood primary hypertension. Hypertension. 2003;42:247–252
  48. Butler R, Morris AD, Belch JJF, Hill A, Struthers AD. Allopurinol normalizes endothelial dysfunction in type 2 diabetics with mild hypertension. Hypertension. 2000;35:746–751
  49. Farquharson CA, Butler R, Hill A, Belch JJ, Struthers AD. Allopurinol improves endothelial dysfunction in chronic heart failure. Circulation. 2002;106:221–226
  50. Doehner W, Schoene N, Rauchhaus M, et al. Effects of xanthine oxidase inhibition with allopurinol on endothelial function and peripheral blood flow in hyperuricemic patients with chronic heart failure. Circulation. 2002;105:2619–2751
  51. Weimert NA, Tanke WF, Sims JJ. Allopurinol as a cardioprotective during coronary artery bypass graft surgery. Ann Pharmacother. 2003;37:1708–1711
  52. Rumberger JA, Simons DB, Fitzpatrick LA, Sheedy PF, Schwartz RS. Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area. A histopathologic correlative study. Circulation. 1995;92:2157–2162
  53. Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC. Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA. 2004;291:210–215
  54. Arad Y, Goodman K, Roth M, Newstein D, Guerci A. Coronary calcification, coronary disease risk factors, C-reactive protein, and atherosclerotic cardiovascular disease events: the St. Francis Heart Study. J Am Coll Cardiol. 2005;46:158–165
  55. Santos RD, Nasir K, Orakzai R, et al. Relation of uric acid levels to presence of coronary artery calcium detected by electron beam tomography in men free of symptomatic myocardial ischemia with versus without the metabolic syndrome. Am J Cardiol. 2007;99:42–45
  56. Santos RD, Nasir K, Rumberger JA, et al. Difference in atherosclerosis burden in different nations and continents assessed by coronary artery calcium. Atherosclerosis. 2006;187:378–384
  57. Tavil Y, Kaya MG, Oktar SÖ, et al. Uric acid level and its association with carotid intimal-media thickness in patients with hypertension. Atherosclerosis. 2008;197:159–163
  58. Iribarren C, Folsom AR, Eckfeldt JH, McGovern PG, Nieto FJ. Correlates of uric acid and its association with asymptomatic carotid atherosclerosis: the ARIC study. Atherosclerosis risk in communities. Ann Epidemiol. 1996;6:331–340
  59. Hoieggen A, et al. The impact of serum uric acid on cardiovascular outcomes in the LIFE study. Kidney Int. 2004;65:1041–1049
  60. Lehto S, Niskanen L, Ronnemaa T, Laakso M. Serum uric acid is a strong predictor of stroke in patients with non-insulin-dependent diabetes mellitus. Stroke. 1998;29:635–639
  61. Choi HK, Curhan G. Independent impact of gout on mortality and risk for coronary heart disease. Circulation. 2007;116:894–900
  62. Strasak A, Ruttmann E, Brant L, et al. Serum uric acid and risk of cardiovascular mortality: a prospective long-term study of 83 683 Austrian men. Clin Chem. 2008;54:273–284
  63. Fang J, Alderman MH. Serum acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971–1992. National Health and Nutrition Examination Survey. JAMA. 2000;283:2404–2410

PII: S0021-9150(08)00357-2

doi: 10.1016/j.atherosclerosis.2008.05.022

Atherosclerosis
Volume 202, Issue 1 , Pages 11-17 , January 2009