Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2010 Feb;62(2):170-80.
doi: 10.1002/acr.20065.

Hyperuricemia and coronary heart disease: a systematic review and meta-analysis

Seo Young Kim  1 , James P Guevara, Kyoung Mi Kim, Hyon K Choi, Daniel F Heitjan, Daniel A Albert
Affiliations
Meta-Analysis

Hyperuricemia and coronary heart disease: a systematic review and meta-analysis

Seo Young Kim et al. Arthritis Care Res (Hoboken). 2010 Feb.

Abstract

Objective: The role of serum uric acid as an independent risk factor for cardiovascular disease remains unclear, although hyperuricemia is associated with cardiovascular disease such as coronary heart disease (CHD), stroke, and hypertension.

Methods: A systematic review and meta-analysis using a random-effects model was conducted to determine the risk of CHD associated with hyperuricemia in adults. Studies of hyperuricemia and CHD were identified by searching major electronic databases using the medical subject headings and keywords without language restriction (through February 2009). Only prospective cohort studies were included if they had data on CHD incidences or mortalities related to serum uric acid levels in adults.

Results: Twenty-six eligible studies of 402,997 adults were identified. Hyperuricemia was associated with an increased risk of CHD incidence (unadjusted risk ratio [RR] 1.34, 95% confidence interval [95% CI] 1.19-1.49) and mortality (unadjusted RR 1.46, 95% CI 1.20-1.73). When adjusted for potential confounding, the pooled RR was 1.09 (95% CI 1.03-1.16) for CHD incidence and 1.16 (95% CI 1.01-1.30) for CHD mortality. For each increase of 1 mg/dl in uric acid level, the pooled multivariate RR for CHD mortality was 1.12 (95% CI 1.05-1.19). Subgroup analyses showed no significant association between hyperuricemia and CHD incidence/mortality in men, but an increased risk for CHD mortality in women (RR 1.67, 95% CI 1.30-2.04).

Conclusion: Hyperuricemia may marginally increase the risk of CHD events, independently of traditional CHD risk factors. A more pronounced increased risk for CHD mortality in women should be investigated in future research.

PubMed Disclaimer

Conflict of interest statement

Financial supports or conflicts disclosure:

- S Kim: NIH T32 (AR 055885 and AR 007442-22)

- HK Choi: Holds the Mary Pack Arthritis Society of Canada Chair in Rheumatology, served on the advisory board for TAP and Savient Pharmaceuticals

- JP Guevara, K Kim, DF Heitjan and DA Albert – None

Figures

Figure 1
Figure 1
Selection of studies included in the analysis. CHD: coronary heart disease
Figure 2
Figure 2
Random effects analysis of multivariate risks of CHD associated with hyperuricemia ES: Effect size, CI: confidence interval
Figure 3
Figure 3
Random effects analysis of multivariate risks of CHD mortality associated with an increase of 1mg/dl in serum uric acid level ES: Effect size, CI: confidence interval
Figure 4
Figure 4
Begg’s funnel plot for publication bias in studies for CHD incidence and mortality
See this image and copyright information in PMC

References

    1. Wu X, Muzny D, Lee C, Caskey C. Two independent mutational events in the loss of urate oxidase during hominoid evolution. J Mol Evol. 1992;34(1):78–84. - PubMed
    1. Oda M, Satta Y, Takenaka O, Takahata N. Loss of urate oxidase activity in hominoids and its evolutionary implications. Mol Biol Evol. 2002;19(5):640–53. - PubMed
    1. Ames B, Cathcart R, Schwiers E, Hochstein P. Uric acid provides an antioxidant defense in humans against oxidant- and radical-caused aging and cancer: a hypothesis. Proc Natl Acad Sci U S A. 1981;78(11):6858–62. - PMC - PubMed
    1. Baker J, Krishnan E, Chen L, Schumacher H. Serum uric acid and cardiovascular disease: recent developments, where do they leave us? Am J Med. 2005;118:816–26. - PubMed
    1. Becker M, Jolly M. Hyperuricemia and associated diseases. Rheum Dis Clin N Am. 2006;32:275–93. - PubMed

Publication types

LinkOut - more resources