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Q J Med 2000; 93: 707-713
© 2000 Association of Physicians

Review

Uric acid as a risk factor for cardiovascular disease

W.S. Waring, D.J. Webb and S.R.J. Maxwell

From the Clinical Pharmacology Unit and Research Centre, Department of Medical Sciences, University of Edinburgh, Edinburgh, UK


   Introduction
 
Over recent years there has been renewed debate about the nature of the association between raised serum uric acid concentration and cardiovascular disease.1 Several large studies have identified the value, in populations, of serum uric acid concentration in predicting the risk of cardiovascular events, such as myocardial infarction. This has directed research towards the potential mechanisms by which uric acid might have direct or indirect effects on the cardiovascular system. It has been difficult to identify the specific role of elevated serum uric acid because of its association with established cardiovascular risk factors such as hypertension, diabetes mellitus, hyperlipidaemia and obesity.2,3 Indeed, it is not even clear at this stage whether uric acid has a damaging or protective effect in these circumstances. Increased understanding of the mechanisms underlying these associations may allow a clearer interpretation of the importance of elevated serum uric acid concentrations, and the potential value of specific . . . [Full Text of this Article]


   Uric acid synthesis
 

   Uric acid as a risk factor for cardiovascular disease
 

   Uric acid as a marker of subclinical ischaemia
 

   Uric acid as a marker of insulin resistance
 

   Direct impact of uric acid on vascular function
 

   Conclusions
 

   Acknowledgments
 

   Notes
 

   References
 

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