Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease?
Hyperuricemia is associated with hypertension, vascular disease, renal disease, and cardiovascular events. In this report, we review the epidemiologic evidence and potential mechanisms for this association. We also summarize experimental studies that demonstrate that uric acid is not inert but may have both beneficial functions (acting as an antioxidant) as well as detrimental actions (to stimulate vascular smooth muscle cell proliferation and induce endothelial dysfunction). A recently developed experimental model of mild hyperuricemia also provides the first provocative evidence that uric acid may have a pathogenic role in the development of hypertension, vascular disease, and renal disease. Thus, it is time to reevaluate the role of uric acid as a risk factor for cardiovascular disease and hypertension and to design human studies to address this controversy.
Johnson
Richard J
RJ
Division of Nephrology, Baylor College of Medicine, SM-1273, 6550 Fannin St, Houston, Tex 77030, USA. rjohnson@bcm.tmc.edu
Kang
Duk-Hee
DH
Feig
Daniel
D
Kivlighn
Salah
S
Kanellis
John
J
Watanabe
Susumu
S
Tuttle
Katherine R
KR
Rodriguez-Iturbe
Bernardo
B
Herrera-Acosta
Jaime
J
Mazzali
Marilda
M
D000818:Animals; D000975:Antioxidants / Q000378:metabolism; D002316:Cardiotonic Agents / Q000097:blood; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D033461:Hyperuricemia / Q000150:complications*; D007674:Kidney Diseases / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008955:Models, Cardiovascular; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
D000975:Antioxidants; D002316:Cardiotonic Agents; D014527:Uric Acid