Hyperuricemia and global Cardiovascular Risk: State of the art and preventive prospects

Over the last years, scientific research has focused its interest on a potential role of hyperuricemia as cardiovascular risk factor; main interest has been directed to persistent raised plasma levels of uric acid. Although some studies have not shown a close correlation between hyperuricemia and cardiovascular risk, most scientific evidence agrees that hyperuricemia plays a key role in determining cardiovascular events and in development of other risk factors often associated with only moderately increased serum uric acid levels. Pathophysiological mechanism underlying this association mainly include a hyperuricemia induced endothelial dysfunction, inflammatory and oxidative stress induced by high serum uric acid levels. Early diagnosis, follow-up and prevention programs and effective treatment of hyperuricemia are recommended in particular in patients with other concomitant cardiovascular risk factors. Urate-lowering therapy should be aimed at reaching at least a serum uric acid level below 6 mg/dL (360 μmol/L) though in high risk patients the lowest possible value of uric acid is better.