Uric acid and influence of hyperuricaemia therapy on prevention of atheroscleroris and cardiovascular diseases

Authors: Ubica Cibičková;  Martin Žurek
Authors‘ workplace: III. interní klinika – nefrologie, revmatologie, endokrinologie LF UP v Olomouci a FN Olomouc
Published in: AtheroRev 2020; 5(1): 27-30


According to current knowledge, uric acid plays an important role in pathogenesis of civilization diseases, including cardiovascular diseases. Uric acid has become an independent risk factor of morbidity and mortality. We summarize current knowledge about relationship of uric acid and cardiovascular risk and influence of allopurinol on cardiovascular diseases.


Atherosclerosis – allopurinol – Uric acid

  1. Sucharda P. Překvapivě starý kostlivec ve skříni – editorial. Vnitř Lék 2015; 61(1): 10–12.
  2. Kanbay M, Jensen T, Solak Y et al. Uric acid in metabolic syndrome: From an innocent bystander to a central player. Eur J Intern Med 2016; 29: 3–8. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ejim.2015.11.026>.
  3. Němec P. Dna a kardiovaskulární riziko. Vnitř Lék 2014; 60(10): 893–901.
  4. Feig DI, Kang D-H, Johnson R. Uric acid and cardiovascular risk. N Eng J Med 2008; 359(17): 1811–1821. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMra0800885>.
  5. Richette P, Bardin T. Gout. Lancet 2010; 375(9711): 318–328. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(09)60883–7>.
  6. Cibickova L, Karasek D. Kyselina močová jako rizikový faktor kardiovaskulárních onemocnění. Vnitř Lék 2016; 62(11): 919–923.
  7. Kanellis J, Kang DH. Uric acid as a mediator of endothelial dysfunction, inflammation, and vascular disease. Semin Nephrol 2005; 25(1): 39–42. Dostupné z DOI: <http://dx.doi.org/10.1016/j.semnephrol.2004.09.007>.
  8. Kelkar A, Kuo A, Frishman WH. Allopurinol as a cardiovascular drug. Cardiol Rev 2011; 19(6): 265–271. Dostupné z DOI: <http://dx.doi.org/10.1097/CRD.0b013e318229a908>.
  9. Feig DI, Kang DH, Johnson RJ. Uric acid and cardiovascular risk. N Engl J Med 2008 Oct; 359(17): 1811–1821. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMra0800885>.
  10. Koborova I, Gurecka R, Hlavata A et al. Asymptomatická hyperurikémie a matebolický syndróm u mladistvých. Vnitř Lék 2015; 61(1): 47–49.
  11. Spahic E, Hasic S, Kiseljakovic E et al. Positive correlation between uric acid and C-reactive protein serum level in healthy individuals and patients with acute coronary syndromes. Med Glas (Zenica) 2015; 12(2): 128–32. Dostupné z DOI: <http://dx.doi.org/10.17392/821–15>.
  12. Sun H-L, Pie D, Lue K-H et al. Uric Acid Levels Can Predict Metabolic Syndrome and Hypertension in Adolescents: A 10-Year Longitudinal Study. PLoS ONE 2015; 10(11): e0143786. Dostupné z DOI: <http://dx.doi.org/10.1371/journal.pone.0143786>.
  13. Cibickova L, Langova K, Vaverkova H et al. Correlation of uric acid levels and parameters of metabolic syndrome. Phys Res 2017; 66(3): 481–487. Dostupné z DOI: <http://dx.doi.org/10.33549/physiolres.933410>.
  14. Kaptoge S, Di Angelantonio E, Lowe G et al. C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet 2010; 375(9709): 132–140. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(09)61717–7>.
  15. Johnson RJ, Tittre S, Cade JR et al. Uric acid, evolution and primitive cultures. Semin Nephrol 2005; 25(1): 3–8. Dostupné z DOI: <http://dx.doi.org/10.1016/j.semnephrol.2004.09.002>.
  16. Stack AG, Hanley A, Casserly LF et al. Independent and conjoint associations of gout and hyperuricaemia with total and cardiovascular mortality. QJM 2013; 106(7): 647–658. Dostupné z DOI: <http://dx.doi.org/10.1093/qjmed/hct083>.
  17. De Vera MA, Rahman MM, Bhole V et al. Independent impact of gout on the risk of acute myocardial infarction among elderly women: a population-based study. Ann. Rheum. Dis 2010; 69(6): 1162–1164. Dostupné z DOI: <http://dx.doi.org/10.1136/ard.2009.122770>.
  18. Baker JF, Schumacher HR, Krishnan E. Serum uric acid level and risk for peripheral arterial disease: analysis of data from the multiple risk factor intervention trial. Angiology 2007; 58(4): 450–457. Dostupné z DOI: <http://dx.doi.org/10.1177/0003319707303444>.
  19. Singh JA, Cleveland J. Allopurinol and the risk of incident peripheral arterial disease in the elderly: a US Medicare claims data study. Rheumatology (Oxford) 2018; 57(3): 451–461. Dostupné z DOI: <http://dx.doi.org/10.1093/rheumatology/kex232>.
  20. Krishnan E. Gout and the risk for incident heart failure and systolic dysfunction. BMJ Open 2012; 2(1): e000282. Dostupné z DOI: <http://dx.doi.org/10.1136/bmjopen-2011–000282>.
  21. Seminog OO, Goldacre MJ. Gout as a risk factor for myocardial infarction and stroke in England: evidence from record linkage studies. Rheumatology (Oxford) 2013; 52(12): 2251–2259. Dostupné z DOI: <http://dx.doi.org/10.1093/rheumatology/ket293>.
  22. Okafor ON, Farrington K, Gorog DA. Allopurinol as a therapeutic option in cardiovascular disease. Pharmacol Ther 2017; 172: 139–150. Dostupné z DOI: <http://dx.doi.org/10.1016/j.pharmthera.2016.12.004>.
  23. Lottmann K, Chen X, Schadlich PK. Association between gout and all-cause as well as cardiovascular mortality: a systematic review. Curr Rheumatol Rep 2012; 14(2): 195–203. Dostupné z DOI: <http://dx.doi.org/10.1007/s11926–011–0234–2>.
  24. Zhu Y, Pandya BJ, Choi HK. Comorbidities of gout and hyperuricemia in the US general population: NHANES 2007–2008. Am J Med 2012; 125(7): 679–687. Dostupné z DOI: <http://dx.doi.org/10.1016/j.amjmed.2011.09.033>.
  25. Perez-Ruiz F, Martínez-Indart L, Carmona L et al. Tophaceous gout and high level of hyperuricaemia are both associated with increased risk of mortality in patients with gout. Ann Rheum Dis 2014; 73(1): 177–182. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2012–202421>.
  26. Linhart A, Rob D. Význam kyseliny močové a terapie alopurinolem v ovlivnění kardiovaskulárních onemocnění. Vnitř Lék 2015; 61(5): 421–430.
  27. Singh JA, Cleveland JD. Gout and the Risk of Incident Obstructive Sleep Apnea in Adults 65 Years or Older: An Observational Study. J Clin Sleep Med 2018; 14(9): 1521–1527. Dostupné z DOI: <http://dx.doi.org/10.5664/jcsm.7328>.
  28. Dogan A, Yarlioglues M, Kaya MG et al. Effect of long-term and high-dose allopurinol therapy on endothelial function in normotensive diabetic patients. Blood Press 2011; 20(3): 182–187. Dostupné z DOI: <http://dx.doi.org/10.3109/08037051.2010.538977>.
  29. Liu P, Wang H, Zhang F et al. The Effects of Allopurinol on the Carotid Intima-media Thickness in Patients with Type 2 Diabetes and Asymptomatic Hyperuricemia: A Three-year Randomized Parallel-controlled Study. Intern Med 2015; 54(17): 2129–2137. Dostupné z DOI: <http://dx.doi.org/10.2169/internalmedicine.54.4310>.
  30. Feig DI, Soletsky B, Johnson RJ. Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension: a randomized trial. JAMA 2008; 300(8): 924–932. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.300.8.924>.
  31. Gois PHF, Souza ERM. Pharmacotherapy for hyperuricemia in hypertensive patients. Cochrane Database Syst Rev 2017; (4):CD008652. Dostupné z DOI: <http://dx.doi.org/10.1002/14651858.CD008652.pub3>.
  32. Noman A, Ang DS, Ogston S et al. Effect of high-dose allopurinol on exercise in patients with chronic stable angina: a randomised, placebo controlled crossover trial. Lancet 2010; 375(9732): 2161–2167. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(10)60391–1>.
  33. Rentoukas E, Tsarouhas K, Tsitsimpikou C et al. The prognaotic impal of allopurinol in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention. Int J Cardiol 2010; 145(2): 257–258. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ijcard.2009.08.037>.
  34. Kok VC, Horng JT, Chang WS et al. Allopurinol therapy in gout patients does not associate with beneficial cardiovascular outcomes: a population-based matched-cohort study. PLoS One 2014; 9(6):e99102. Dostupné z DOI: <http://dx.doi.org/10.1371/journal.pone.0099102>.
  35. Robertson AJ, Struthers AD. A Randomized Controlled Trial of Allopurinol in Patients with Peripheral Arterial Disease. Can J Cardiol 2016; 32(2): 190–196. Dostupné z DOI: <http://dx.doi.org/10.1016/j.cjca.2015.05.010>.
  36. Cuenca JA, Balda J, Palacio A et al. Febuxostat and Cardiovascular Events: A Systematic Review and Meta-Analysis. Int J Rheumatol 2019; 2019: 1076189. Dostupné z DOI: <http://dx.doi.org/10.1155/2019/1076189>.
  37. Liu CW, Chang WC, Lee CC et al. The net clinical benefits of febuxostat versus allopurinol in patients with gout or asymptomatic hyperuricemia – A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2019; 29(10): 1011–1022. Dostupné z DOI: <http://dx.doi.org/10.1016/j.numecd.2019.06.016>
Angiology Diabetology Internal medicine Cardiology General practitioner for adults
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