High uric acid may trigger heart attacks: Symptoms, risks, and prevention

High uric acid , medically known as hyperuricaemia , is increasingly recognized as an independent risk factor for heart attacks and other cardiovascular diseases , according to a comprehensive review published by the European Society of Cardiology (ESC). Uric acid is the final product of purine metabolism and is primarily excreted through the kidneys and intestines. When serum uric acid (SUA) levels rise above 6.0 mg/dL in women and 7.0 mg/dL in men, it can lead to endothelial dysfunction, oxidative stress, and systemic inflammation, which are mechanisms that contribute to atherosclerosis and coronary artery disease. Research shows that high uric acid may amplify other risk factors like hypertension and diabetes, increasing the likelihood of heart attacks.

Symptoms of high uric acid
High uric acid often develops silently, but some individuals may experience:

• Gout: Sudden, intense joint pain, often at the big toe, but also in ankles, knees, wrists, and fingers. Joints may be swollen, red, tender, and warm.
• Joint stiffness: Especially in the morning or after inactivity, with lingering discomfort lasting weeks.
• Kidney stones: Sharp pain in the side or back, blood in urine, nausea, frequent urination, or foul-smelling urine.
• Other signs: Tingling or mild puffiness in joints, sometimes without noticeable pain.

Risks of high uric acid
Studies, including epidemiological, genetic, and Mendelian randomization analyses, link elevated uric acid to major cardiovascular events:

• Coronary artery disease (heart attack)
• Heart failure
• Hypertension and type 2 diabetes
• Chronic kidney disease

Large-scale studies, such as the Italian URRAH multicentre study with over 20,000 outpatients, showed a direct correlation between high SUA and increased cardiovascular and all-cause mortality. Each 1 mg/dL increase in SUA was associated with a higher hazard ratio for cardiovascular death.

Prevention and management of uric acid
Preventing high uric acid involves lifestyle modifications, dietary measures, and medical management when needed:

• Limit high-purine foods such as red meat, organ meats, and seafood.
• Avoid sugary drinks and foods with high fructose.
• Drink plenty of water to support kidney excretion.
• Limit alcohol intake, especially beer and spirits.
• Maintain a healthy weight and engage in regular physical activity.
• Manage conditions like hypertension, diabetes, or kidney disease.
• Regular monitoring of serum uric acid, especially for those with family history or previous gout or kidney stones.

High uric acid is more than just a metabolic concern. It is a proven independent risk factor for heart attacks and cardiovascular complications. Early recognition, lifestyle adjustments, and medical supervision can reduce risks and protect heart health.