title: Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease?
abstract: 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.
authors.affiliation: Division of Nephrology, Baylor College of Medicine, SM-1273, 6550 Fannin St, Houston, Tex 77030, USA. rjohnson@bcm.tmc.edu
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Johnson
authors.forename: Duk-Hee
authors.initials: DH
authors.lastname: Kang
authors.forename: Daniel
authors.initials: D
authors.lastname: Feig
authors.forename: Salah
authors.initials: S
authors.lastname: Kivlighn
authors.forename: John
authors.initials: J
authors.lastname: Kanellis
authors.forename: Susumu
authors.initials: S
authors.lastname: Watanabe
authors.forename: Katherine R
authors.initials: KR
authors.lastname: Tuttle
authors.forename: Bernardo
authors.initials: B
authors.lastname: Rodriguez-Iturbe
authors.forename: Jaime
authors.initials: J
authors.lastname: Herrera-Acosta
authors.forename: Marilda
authors.initials: M
authors.lastname: Mazzali
mesh_terms: 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*
chemical_list: D000975:Antioxidants; D002316:Cardiotonic Agents; D014527:Uric Acid