Uric acid and cardiovascular disease: A clinical review

•Elevated serum uric acid levels are associated with cardiovascular diseases.•Serum uric acid is also useful for predicting future cardiovascular outcomes.•Whether uric acid is a causal risk factor of cardiovascular disease remains unknown.•Some clinical benefits of urate-lowering therapy have been shown in small studies.•The efficacy of urate-lowering therapy is not yet established in large-scale trials. Uric acid, the end-product of purine metabolism in humans, is not only a cause of gout, but also may play roles in developing cardiovascular diseases such as hypertension, atrial fibrillation, chronic kidney disease, heart failure, coronary artery disease, and cardiovascular death. Several clinical investigations have reported serum uric acid as a predictive marker for cardiovascular outcomes. Although the causal relationship of hyperuricemia to cardiovascular diseases remains controversial, there has been a growing interest in uric acid because of the increased prevalence of hyperuricemia worldwide. This review article summarizes current evidence concerning the relation between hyperuricemia and cardiovascular diseases.