title: Uric acid lowering therapy in cardiovascular diseases.
abstract: Recent evidence would indicate that high serum uric acid (SUA) levels can be a significant and independent risk factor for hypertension and cardiovascular diseases, such as ischemic heart disease and heart failure. In the last few years an independent risk relationship between hyperuricemia, cardiovascular disease and mortality has also been reported. Hyperuricemia has been shown as an independent risk factor for acute myocardial infarction and an independent and conjoint association of either gout and SUA with total and cardiovascular mortality has been reported, with mortality impact in gout patients increasing with rising SUA concentrations, even for SUA levels in the normal to high range. These findings prompted a growing research interest on the possible benefits of uric acid lowering drugs in cardiovascular diseases. Indeed, clinical studies have reported on the beneficial effects of uric acid lowering drugs, in particular of xanthine oxidase inhibitors, in hypertension, ischemic heart disease and heart failure. Two main mechanisms have been claimed to explain the dangerous effects of hyperuricemia and, as a consequence, the benefits of uric acid lowering therapy: endothelial dysfunction and systemic inflammation. This brief review aims to summarize current evidence from human studies on the role of acid uric lowering therapy in cardiovascular diseases for practical and clinical purposes. The possible mechanisms underlying the benefits of acid uric lowering therapy are also addressed.
authors.affiliation: Dipartimento di Cardiologia, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Pisana, Rome, Italy. Electronic address: maurizio.volterrani@sanraffaele.it.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Volterrani
authors.affiliation: Dipartimento Medicina dei Sistemi, Università Tor Vergata, Rome, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Iellamo
authors.affiliation: Dipartimento di Cardiologia, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Pisana, Rome, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Sposato
authors.affiliation: Dipartimento di Cardiologia e Cardiologia Interventistica UTIC Policlinico Tor Vergata, Rome Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Romeo
mesh_terms: D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000209:etiology; D004791:Enzyme Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D006073:Gout / Q000188:drug therapy / Q000401:mortality; D006074:Gout Suppressants / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D033461:Hyperuricemia / Q000188:drug therapy*; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood*; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors
chemical_list: D004791:Enzyme Inhibitors; D006074:Gout Suppressants; D014527:Uric Acid; D014969:Xanthine Oxidase
keywords: Cardiovascular diseases; Uric acid; Xanthine oxidase activity; Xanthine oxidase inhibition