Hyperuricaemia and vascular risk: the debate continues

Purpose of review To update the evidence about the role of elevated levels of uric acid as a risk factor for cardiovascular disease. The review includes the most recent epidemiological evidence as well as the possible mechanisms supporting the interaction between uric acid and cardiovascular, metabolic and renal disease. Recent findings The confirmed role of uric acid as involved in the onset and progression of cardiovascular and metabolic diseases. In particular, the review will focus on the possible mechanism of action of uric acid and the level of involvement of xanthine-oxidase as a mechanism responsible for both hyperuricaemia and oxidative stress. The review also briefly summarizes the most recent findings of the studies carried out with xanthine-oxidase inhibitors in patients at risk of cardiovascular disease by focusing on the possible benefits. Summary Elevated levels of serum uric acid have been demonstrated to be closely related to the development of cardiovascular, metabolic and renal disease. The mechanism responsible for such interaction directly or indirectly involves xanthine-oxidase activation and the inflammatory system leading to structural and functional abnormalities. Preliminary results from different trials have demonstrated the favourable effects of urate-lowering treatment in the prevention of cardiovascular disease beyond the treatment of gout.