Uric acid or hyperuricemia and its link with heart disease: 3 important things to know

Uric acid is a waste product which is naturally formed in the body when it breaks down purines— which is a compounds often found in foods like red meat, seafood, and alcohol. In normal circumstances, uric acid dissolves in the blood; it is then filtered out by the kidneys, and removed from the body along with urine. But when uric acid levels in the blood get too high, it leads to a condition called hyperuricemia develops, which causes health issues like gout, kidney stones, and, surprisingly even heart disease. Scientific study shows that high uric acid isn’t just a joint problem— it may also play a role in one's cardiovascular health. A 2023 study of 10,486 coronary artery disease patients showed that higher uric acid levels are linked to worse cardiovascular outcomes, including death and myocardial infarction. It also discusses uric acid's role in oxidative stress and inflammation affecting cardiovascular risk.
While uric acid in the body is not always harmful, its buildup and high levels are certainly alarming and should not be left untreated. Here we list some important things you need to know about the connection between uric acid and heart disease:

Studies show that elevated uric acid levels can damage the lining of blood vessels and reduce nitric oxide, which is important for keeping arteries flexible. And so, high uric acid levels in the body can lead to narrowing and stiffening of blood vessels, thus increasing blood pressure. Over time, if high uric acid levels are left untreated it can lead to chronic hypertension— which is a major risk factor for heart disease. And so, people with hyperuricemia are especially at risk of developing early hypertension. Maintaining healthy uric acid levels in the body through lifestyle changes-- including diet and regular exercise-- can help reduce this risk significantly.

Excess uric acid in the body also causes inflammation and oxidative stress, both of which are harmful to heart health. Over time, chronic inflammation can accelerate the buildup of plaque in the arteries (atherosclerosis), thus increasing one's chance of getting heart attacks and strokes. In fact, some researchers believe uric acid is an independent predictor of heart disease, even when other factors like cholesterol are under control.
A 2008 study found serum uric acid levels independently predicted death in patients at high cardiovascular risk after adjusting for multiple factors including cholesterol. Each 1 mg/dl increase in uric acid raised death risk by 26%.

This makes reducing high uric acid levels important for having good heart health in the long run.

While studies have shown the link between high uric acid levels and increased heart attacks, the good news is that making certain lifestyle changes and taking necessary medications in some cases can help lower uric acid levels and protect the heart. Staying hydrated, limiting alcohol and purine-rich foods (like red meat, sea food, lentils, peas, and beans), and maintaining a healthy weight are some ways to reduce uric acid levels. For people with severe hyperuricemia, doctors may prescribe medications such as allopurinol to keep uric acid levels in check. Regular health check-ups, including uric acid testing, can act as an early warning system to prevent long-term complications, including heart disease.