The role of serum uric acid as a risk factor for CV disease has been extensively debated for many years
without reaching a final agreement among clinicians and researchers. In particular, most of the
evidence about the pathogenetic role of uric acid in CV disease have been achieved in the population of
patients with severe hyperuricemia or gout while its role in patients with mildly elevated serum levels
of uric acid is only poorly recognized. Serum uric acid represents an important, independent risk factor
for cardiovascular and renal disease in patients with hypertension, heart failure, or diabetes. Elevated
serum uric acid is highly predictive of mortality in patients with heart failure or coronary artery disease
and of cardiovascular events in patients with diabetes. Although the mechanism(s) by which uric acid
may play a pathogenetic role in cardiovascular disease is still unclear, hyperuricemia is associated with
deleterious effects on endothelial dysfunction, oxidative metabolism, platelet adhesiveness,
hemrheology, and aggregation. Whether a reduction in uric acid impacts CV and renal disease remains
to be determined. However, recent findings from LIFE suggest the possibility that a treatment-induced
decrease in serum uric acid may indeed attenuate cardiovascular risk. Clearly, randomized clinical
trials are needed to investigate further the long-term cardioprotective benefits issue of reducing
hyperuricemia in hypertensive patients..
The main purpose of the present symposium is twofold. First of all to reinforce the role of uric acid in
the pathogenesis of gout and gout-related non-rheumatic diseases including renal involvement. Second
to provide an updated review of the evidence supporting a possible and relevant role of (elevated) uric
acid as a risk factor for cardiovascular diseases. To fullfil this goal we will present a series of
comprehensive lectures mainly focused on the different aspects of the relationship between serum uric
acid and cardiovascular diseases with the aim to define whether or not the increase in the amount of our
knowledge about uric acid may contribute to increase the number of major risk factors.
Presidents of the Meeting
Claudio Borghi and Richard J. Johnson