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Expert consensus for the diagnosis and treatment of patients with hyperuricemia and high cardiovascular risk: 2025 update - PubMed

5 days ago
  • #Cardiovascular Risk
  • #Uric Acid
  • #Hyperuricemia
  • Hyperuricemia is linked to increased cardiovascular and renal risks, not just gout.
  • Recent studies show adverse outcomes can occur at serum uric acid levels below classic thresholds, especially in high cardiovascular risk patients.
  • A multidisciplinary European panel developed consensus recommendations based on literature review, including large cohort studies and randomized trials.
  • Hyperuricemia is prevalent among individuals with hypertension, chronic kidney disease, obesity, diabetes, and cardiovascular disease.
  • Elevated serum uric acid is independently associated with cardiovascular mortality, heart failure, stroke, and faster kidney disease progression.
  • Randomized trials have not shown clear cardiovascular or renal benefits from routine urate-lowering therapy in asymptomatic hyperuricemia patients.
  • The consensus recommends a risk-based, individualized approach to hyperuricemia management, including lifestyle measures and pharmacological therapy when needed.
  • Hyperuricemia should be recognized as a significant cardiovascular and renal risk factor.
  • Serum urate measurement can improve risk stratification in high-risk populations.
  • Targeted urate-lowering strategies may be appropriate for high cardiovascular risk patients, symptomatic disease, or very high serum uric acid levels.
  • Future trials are needed to determine if urate-lowering therapy can improve hard cardiovascular and renal outcomes.