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Hyperuricemia and cardiovascular disease: How strong is the evidence for a causal link?
Arthritis Research & Therapy, 08/24/09

Gaffo AL et al. – Review presents recently published animal, clinical, and epidemiological evidence that is contributing to a re-appraisal of the association between serum urate and cardiovascular diseases with a final conclusion about the possibility of this association being causal. Some of the comments in view of current evidence:

• Associations with hypertension and CV mortality are not found to be particularly strong, with an exception of the strong association being recently described with chronic kidney disease
• Most associations have been described in US and European Caucasian populations; some large epidemiological studies are not in favor of it
• The question of hyperuricemia being a causative factor for CV disease at all, or just a well-hidden confounder, has not been conclusively answered
• Large epidemiological studies in mortality of CV diseases and development of chronic kidney disease have established compelling dose-dependent relationships with population concns of serum urate
• Experiments in animal models have added urate-lowering agents to revert renal vascular disease caused by hyperuricemia
• In conclusion, the paradigm of the causative association of hyperuricemia and CV diseases seems to have progressed from one of skepticism to one of increasing evidence of a true relationship

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