The differential role of uric acid - The purpose or cause of cardiovascular diseases?

Med Hypotheses. 2020 Sep:142:109791. doi: 10.1016/j.mehy.2020.109791. Epub 2020 May 1.

Abstract

For 40 years many studies have been conducted to verify the connection between serum uric acid concentration and cardiovascular diseases, such as myocardial infarction. Unfortunately, it remains unclear which form of uric acid - prooxidant or antioxidant - could be a predictive marker of cardiovascular disease, especially in patients after myocardial infarction. It is well-known that uric acid is an organic compound and the water-soluble final product of purine catabolism, which is catalysed by xanthine oxidoreductase and excreted by kidneys. An increased concentration of UA in human plasma leads to diseases like tumours, renal disorders, atherosclerosis, hypertension, diabetes, metabolic syndrome, polycythaemia vera, haemolytic anaemias, ischemia, oxidative stress, and rare genetic disorders connected with UA degradation. Epidemiological studies have shown that UA might be a marker of oxidative stress, progression of inflammation, or renal disease. A fortiori, it is possible that could also be a predictor for short/long-term survival of patients with CVD. Evidence provided by multiple studies is controversial and mutually exclusive. Among 71 studies the most of them found an independent association between SUA and CVD risk. Some of those studies confirm that CVD risk is higher in women who had elevated SUA levels. On the other hand, many studies reached the opposite conclusion and did not find any relationship between SUA and CVD mortality and morbidity.

Keywords: Antioxidant; Cardiovascular disease; Epidemiological studies; Prooxidant; Uric acid; Uric acid-lowering therapy.

MeSH terms

  • Antioxidants
  • Biomarkers
  • Cardiovascular Diseases*
  • Female
  • Humans
  • Hypertension*
  • Oxidative Stress
  • Risk Factors
  • Uric Acid

Substances

  • Antioxidants
  • Biomarkers
  • Uric Acid