According to the WHO, hypertension is one of the primary risk factors for heart disease and stroke, the leading causes of death worldwide1. It has been established that in a few cases the development of the disease is affected by an increased level of uric acid, and hyperuricemia as a risk factor is included in the European (2018) and Russian (2019) recommendations for hypertension2. Moreover, an increase in the target level of Uric Acid (UA) increases the risk of developing other microvascular and macrovascular diseases: metabolic syndrome, coronary heart disease, diabetes, cerebrovascular accident, chronic kidney disease3,4,5.
Krzysztof Narkiewicz, MD, PhD, professor, head of the Department of Hypertension and Diabetology, Medical University of Gdańsk, Poland, ex-President, European Society of Hypertension, presented the most important studies and European guidelines highlighting the link between elevated sUA and cardiovascular outcomes. In addition, the professor presented the Expert consensus for the diagnosis and treatment of patient with hyperuricemia and high cardiovascular risk.
“Our recommendations based on the available data and statements, point to an optimal target of UA level of 5 mg/dL in patients at high CV risks defined as at least two of the following: hypertension, diabetes, dyslipidemia, recent stroke or MI, and not higher than 6mg/dL for patients not suffering from the above. An increased UA level is a result of a purine/fructose-rich diet, genetic or environmental factors and metabolic disorders. We are sure that patients with HU should be informed about modification of their lifestyle, their diet and weight loss if needed. If these measures are not sufficient, we should consider treatment with allopurinol starting from 100 mg daily, then titrate to 300-600 mg daily to reach the target. It is crucial to continue treatment and monitor sUA levels” – said professor Krzysztof Narkiewicz.