Raised Uric Acid, but Without Gout, Can Still Be Dangerous

If your doctor finds you have a raised blood uric acid level, she/he will ask you about symptoms of gout.  Chances are that, if you don’t have any symptoms or signs, you’ll be told ‘nothing to worry about’.  But that may be a mistake.  A study from Taiwan, reported at the recent American College of Rheumatology meeting, found that so-called ‘asymptomatic hyperuricemia’ should probably be treated with urate-lowering drugs, anyway. 

Researchers examined medical records from 45,000-odd people in a larger database in Taiwan.  They hoped to clarify whether controlling serum uric acid levels with medication could improve cardiovascular outcomes.  Hyperuricemia was defined as levels above 7.7 mg/dL for men or above 6.6 mg/dL for women.

After an average follow-up of 11.3 years, 519 subjects had died of cardiovascular disease (308 men and 211 women).  Overall, cardiovascular deaths (including stroke) were approximately halved in those subjects who had taken uric acid-lowering medication at one time or another.  Hemorrhagic stroke and high blood pressure death rates were reduced the most – the risks were 0.12- and 0.29-times those for people not taking such medications.  And those subjects who continued treatment for high uric acid for more than a year had a much lower risk level for cardiovascular disease than those who’d been treated for less than 2 months.

This analysis shows an apparent effectiveness of uric acid-lowering drugs in protection against cardiovascular disease.  It does not show, unfortunately, whether patients with hyperuricemia without gout symptoms received a similar benefit from such drugs.  This must await a new study. 

In fact, such a study shouldn’t be so difficult to conduct;  the number of people with gout has continued to rise over the previous 20 years.  This may possibly be due to the increased consumption of sugar-sweetened drinks, which contain a lot of fructose.  In the referenced study, there was a clear association between the number of daily servings of sweetened soft drinks and orange juice and the occurrence of gout.