Hyperuricemia and adverse outcomes in cardiovascular disease: potential for therapeutic intervention.
High uric acid levels are associated with increased morbidity and mortality rates in cardiovascular disease. In this article we explore the relationship between cardiovascular disease and xanthine oxidase activity. We look at the evidence that uric acid and its production via the xanthine oxidase pathway, may directly contribute to this increased cardiovascular risk. We examine the relationship between uric acid and other established cardiovascular risk factors and look at the evidence that reducing uric acid production may have a beneficial impact on cardiovascular morbidity and mortality. We conclude that although there is currently insufficient evidence to recommend the routine use of xanthine oxidase inhibitors in those with cardiovascular disease and asymptomatic hyperuricemia, there is sufficient evidence to warrant a large scale morbidity and mortality trial.
Gavin
Andrew R
AR
Department of Clinical Pharmacology, Ninewells Hospital, Dundee DD1 9SY, Scotland.
Struthers
Allan D
AD
D000493:Allopurinol / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy*; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D006801:Humans; D033461:Hyperuricemia / Q000097:blood / Q000188:drug therapy*; D014527:Uric Acid / Q000097:blood; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors
D004791:Enzyme Inhibitors; D014527:Uric Acid; D000493:Allopurinol; D014969:Xanthine Oxidase