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Hyperuricaemia and gout in cardiovascular, metabolic and kidney disease.
Eur J Intern Med. 2020 10; 80:1-11.EJ

Abstract

During the last century, there has been an increasing prevalence of hyperuricaemia noted in many populations. While uric acid is usually discussed in the context of gout, hyperuricaemia is also associated with hypertension, chronic kidney disease, hypertriglyceridaemia, obesity, atherosclerotic heart disease, metabolic syndrome, and type 2 diabetes. Here we review the connection between hyperuricaemia and cardiovascular, kidney and metabolic diseases. Contrary to the popular view that uric acid is an inert metabolite of purine metabolism, recent studies suggest serum uric acid may have a variety of pro-inflammatory, pro-oxidative and vasoconstrictive actions that may contribute to cardiometabolic diseases. Hyperuricaemia is a predictive factor for the development of hypertension, metabolic syndrome, type 2 diabetes, coronary artery disease, left ventricular hypertrophy, atrial fibrillation, myocardial infarction, stroke, heart failure and chronic kidney disease. Treatment with uric acid-lowering therapies has also been found to improve outcomes in patients with hypertension and kidney disease, in some but not all studies. In conclusion, uric acid is emerging as a potentially treatable risk factor for cardiometabolic diseases, and more clinical trials investigating the potential benefit of lowering serum uric acid are recommended in individuals with hyperuricaemia with and without deposition and concomitant hypertension, metabolic syndrome or chronic kidney disease.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Borghi C
Department of Medical and Surgical Sciences, Ospedale Malpighi, University of Bologna, Via Albertoni 15, 40138 Bologna, Italy. Electronic address: claudio.borghi@unibo.it.
Agabiti-Rosei E
Department of Clinical and Experimental Sciences, University of Brescia Division of Medicine, Viale Europa, 11 - 25123 Brescia, Italy.
Johnson RJ
Department of Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Ave Aurora, Colorado, United States.
Kielstein JT
Medical Clinic V: Nephrology, Rheumatology and Blood Purification, Academic Teaching Hospital Braunschweig, Salzdahlumer Straβe 90, 38126, Braunschweig, Germany.
Lurbe E
Pediatric Department, General Hospital of Valencia and CIBERObn, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
Mancia G
University of Milano-Bicocca, Piazza dell'AteneoNuovo, 1, 20126 Milan and Policlinico di Monza, Monza, Italy.
Redon J
Hospital Clinic of Valencia, INCLIVA University of Valencia and CIBERObn, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
Stack AG
Department of Nephrology, University Hospital Limerick, Graduate Entry Medical School, University of Limerick, Castletroy, Co. Limerick, V94 T9PX, Ireland.
Tsioufis KP
National and Kapodistrian University of Athens, Athens 15772, Greece.

MeSH

Diabetes Mellitus, Type 2GoutHumansHyperuricemiaMetabolic SyndromeUric Acid

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

32739239

Citation

Borghi, Claudio, et al. "Hyperuricaemia and Gout in Cardiovascular, Metabolic and Kidney Disease." European Journal of Internal Medicine, vol. 80, 2020, pp. 1-11.
Borghi C, Agabiti-Rosei E, Johnson RJ, et al. Hyperuricaemia and gout in cardiovascular, metabolic and kidney disease. Eur J Intern Med. 2020;80:1-11.
Borghi, C., Agabiti-Rosei, E., Johnson, R. J., Kielstein, J. T., Lurbe, E., Mancia, G., Redon, J., Stack, A. G., & Tsioufis, K. P. (2020). Hyperuricaemia and gout in cardiovascular, metabolic and kidney disease. European Journal of Internal Medicine, 80, 1-11. https://doi.org/10.1016/j.ejim.2020.07.006
Borghi C, et al. Hyperuricaemia and Gout in Cardiovascular, Metabolic and Kidney Disease. Eur J Intern Med. 2020;80:1-11. PubMed PMID: 32739239.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hyperuricaemia and gout in cardiovascular, metabolic and kidney disease. AU - Borghi,Claudio, AU - Agabiti-Rosei,Enrico, AU - Johnson,Richard J, AU - Kielstein,Jan T, AU - Lurbe,Empar, AU - Mancia,Giuseppe, AU - Redon,Josep, AU - Stack,Austin G, AU - Tsioufis,Konstantinos P, Y1 - 2020/07/29/ PY - 2020/04/15/received PY - 2020/06/16/revised PY - 2020/07/07/accepted PY - 2020/8/3/pubmed PY - 2021/2/16/medline PY - 2020/8/3/entrez KW - Allopurinol KW - Febuxostat KW - Hypertension KW - Hyperuricaemia KW - Metabolic syndrome KW - Type 2 diabetes SP - 1 EP - 11 JF - European journal of internal medicine JO - Eur J Intern Med VL - 80 N2 - During the last century, there has been an increasing prevalence of hyperuricaemia noted in many populations. While uric acid is usually discussed in the context of gout, hyperuricaemia is also associated with hypertension, chronic kidney disease, hypertriglyceridaemia, obesity, atherosclerotic heart disease, metabolic syndrome, and type 2 diabetes. Here we review the connection between hyperuricaemia and cardiovascular, kidney and metabolic diseases. Contrary to the popular view that uric acid is an inert metabolite of purine metabolism, recent studies suggest serum uric acid may have a variety of pro-inflammatory, pro-oxidative and vasoconstrictive actions that may contribute to cardiometabolic diseases. Hyperuricaemia is a predictive factor for the development of hypertension, metabolic syndrome, type 2 diabetes, coronary artery disease, left ventricular hypertrophy, atrial fibrillation, myocardial infarction, stroke, heart failure and chronic kidney disease. Treatment with uric acid-lowering therapies has also been found to improve outcomes in patients with hypertension and kidney disease, in some but not all studies. In conclusion, uric acid is emerging as a potentially treatable risk factor for cardiometabolic diseases, and more clinical trials investigating the potential benefit of lowering serum uric acid are recommended in individuals with hyperuricaemia with and without deposition and concomitant hypertension, metabolic syndrome or chronic kidney disease. SN - 1879-0828 UR - https://www.unboundmedicine.com/medline/citation/32739239/Hyperuricaemia_and_gout_in_cardiovascular_metabolic_and_kidney_disease_ DB - PRIME DP - Unbound Medicine ER -