Vol 8, No 2 (2022)
Guidelines / Expert consensus
Published online: 2022-06-22

open access

Page views 4647
Article views/downloads 488
Get Citation

Connect on Social Media

Connect on Social Media

Cardiological and rheumatological expert statement on the management of asymptomatic hyperuricemia in patients at high cardiovascular risk

Marcin Barylski1, Bogdan Batko, Krzysztof J. Filipiak, Artur Mamcarz, Maria Rell-Bakalarska, Włodzimierz Samborski, Piotr Wiland
Rheumatology Forum 2022;8(2):43-59.

Abstract

Article published concurrently in: Choroby Serca i Naczyń 2022, 19 (1) 1–18, DOI: 10.5603/ChSiN.2022.0001

Article available in PDF format

View PDF Download PDF file

References

  1. Kratzer JT, Lanaspa MA, Murphy MN, et al. Evolutionary history and metabolic insights of ancient mammalian uricases. Proc Natl Acad Sci U S A. 2014; 111(10): 3763–3768.
  2. Samborski W, Brzosko M. Dna moczanowa i inne choroby wywołane przez kryształy. In: Brzosko M, Fliciński J, Prajs K. ed. Reumatologia praktyczna. Wolters Kluwer Polska, Warszawa 2011.
  3. Ragab G, Elshahaly M, Bardin T. Gout: An old disease in new perspective - A review. J Adv Res. 2017; 8(5): 495–511.
  4. Bardin T, Richette P. Impact of comorbidities on gout and hyperuricaemia: an update on prevalence and treatment options. BMC Med. 2017; 15(1): 123.
  5. Conen D, Wietlisbach V, Bovet P, et al. Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country. BMC Public Health. 2004; 4: 9.
  6. Qiu L, Cheng Xq, Wu J, et al. Prevalence of hyperuricemia and its related risk factors in healthy adults from Northern and Northeastern Chinese provinces. BMC Public Health. 2013; 13: 664.
  7. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum. 2011; 63(10): 3136–3141.
  8. Chen-Xu M, Yokose C, Rai SK, et al. Contemporary Prevalence of Gout and Hyperuricemia in the United States and Decadal Trends: The National Health and Nutrition Examination Survey, 2007-2016. Arthritis Rheumatol. 2019; 71(6): 991–999.
  9. Kumar A U A, Browne LD, Li X, et al. Temporal trends in hyperuricaemia in the Irish health system from 2006-2014: A cohort study. PLoS One. 2018; 13(5): e0198197.
  10. Perez-Ruiz F, Calabozo M, Pijoan JI, et al. Effect of urate-lowering therapy on the velocity of size reduction of tophi in chronic gout. Arthritis Rheum. 2002; 47(4): 356–360.
  11. Kuo CF, Grainge MJ, Zhang W, et al. Global epidemiology of gout: prevalence, incidence and risk factors. Nat Rev Rheumatol. 2015; 11(11): 649–662.
  12. Hall AP, Barry P, Dawber T, et al. Epidemiology of gout and hyperuricemia. The American Journal of Medicine. 1967; 42(1): 27–37.
  13. Schlesinger N, Norquist JM, Watson DJ. Serum urate during acute gout. J Rheumatol. 2009; 36(6): 1287–1289.
  14. Prasad M, Matteson EL, Herrmann J, et al. Uric Acid Is Associated With Inflammation, Coronary Microvascular Dysfunction, and Adverse Outcomes in Postmenopausal Women. Hypertension. 2017; 69(2): 236–242.
  15. Farquharson CAJ, Butler R, Hill A, et al. Allopurinol improves endothelial dysfunction in chronic heart failure. Circulation. 2002; 106(2): 221–226.
  16. Watanabe S, Kang DH, Feng L, et al. Uric acid, hominoid evolution, and the pathogenesis of salt-sensitivity. Hypertension. 2002; 40(3): 355–360.
  17. Lin C, Zhang Pu, Xue Y, et al. Link of renal microcirculatory dysfunction to increased coronary microcirculatory resistance in hypertensive patients. Cardiol J. 2017; 24(6): 623–632.
  18. Kang DH, Park SK, Lee IK, et al. Uric acid-induced C-reactive protein expression: implication on cell proliferation and nitric oxide production of human vascular cells. J Am Soc Nephrol. 2005; 16(12): 3553–3562.
  19. Corry DB, Eslami P, Yamamoto K, et al. Uric acid stimulates vascular smooth muscle cell proliferation and oxidative stress via the vascular renin-angiotensin system. J Hypertens. 2008; 26(2): 269–275.
  20. Kang DH, Han L, Ouyang X, et al. Uric acid causes vascular smooth muscle cell proliferation by entering cells via a functional urate transporter. Am J Nephrol. 2005; 25(5): 425–433.
  21. Feig DI, Nakagawa T, Karumanchi SA, et al. Hypothesis: Uric acid, nephron number, and the pathogenesis of essential hypertension. Kidney Int. 2004; 66(1): 281–287.
  22. Lee JE, Kim YG, Choi YH, et al. Serum uric acid is associated with microalbuminuria in prehypertension. Hypertension. 2006; 47(5): 962–967.
  23. Iseki K, Oshiro S, Tozawa M, et al. Significance of hyperuricemia on the early detection of renal failure in a cohort of screened subjects. Hypertens Res. 2001; 24(6): 691–697.
  24. Furukawa S, Fujita T, Shimabukuro M, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest. 2004; 114(12): 1752–1761.
  25. Cannon PJ, Stason WB, Demartini FE, et al. Hyperuricemia in primary and renal hypertension. N Engl J Med. 1966; 275(9): 457–464.
  26. Ford ES, Li C, Cook S, et al. Serum concentrations of uric acid and the metabolic syndrome among US children and adolescents. Circulation. 2007; 115(19): 2526–2532.
  27. Puig JG, Martínez MA. Hyperuricemia, gout and the metabolic syndrome. Curr Opin Rheumatol. 2008; 20(2): 187–191.
  28. Tuttle K, Short R, Johnson R. Sex differences in uric acid and risk factors for coronary artery disease. The American Journal of Cardiology. 2001; 87(12): 1411–1414.
  29. Dehghan A, van Hoek M, Sijbrands EJG, et al. High serum uric acid as a novel risk factor for type 2 diabetes. Diabetes Care. 2008; 31(2): 361–362.
  30. Schretlen DJ, Inscore AB, Vannorsdall TD, et al. Serum uric acid and brain ischemia in normal elderly adults. Neurology. 2007; 69(14): 1418–1423.
  31. Lehto S, Niskanen L, Rönnemaa T, et al. Serum uric acid is a strong predictor of stroke in patients with non-insulin-dependent diabetes mellitus. Stroke. 1998; 29(3): 635–639.
  32. Yu KH, Kuo CF, Luo SF, et al. Risk of end-stage renal disease associated with gout: a nationwide population study. Arthritis Res Ther. 2012; 14(2): R83.
  33. Abbott RD, Brand FN, Kannel WB, et al. Characteristics and prognosis of lone atrial fibrillation. 30-year follow-up in the Framingham Study. JAMA. 1985; 254(24): 3449–3453.
  34. De Vera MA, Rahman MM, Bhole V, et al. Independent impact of gout on the risk of acute myocardial infarction among elderly women: a population-based study. Ann Rheum Dis. 2010; 69(6): 1162–1164.
  35. Borghi C, Rosei EA, Bardin T, et al. Serum uric acid and the risk of cardiovascular and renal disease. J Hypertens. 2015; 33(9): 1729–41; discussion 1741.
  36. Kleber ME, Delgado G, Grammer TB, et al. Uric Acid and Cardiovascular Events: A Mendelian Randomization Study. J Am Soc Nephrol. 2015; 26(11): 2831–2838.
  37. Yan D, Wang J, Jiang F, et al. A causal relationship between uric acid and diabetic macrovascular disease in Chinese type 2 diabetes patients: A Mendelian randomization analysis. Int J Cardiol. 2016; 214: 194–199.
  38. Kuwabara M, Borghi C, Cicero AFG, et al. Elevated serum uric acid increases risks for developing high LDL cholesterol and hypertriglyceridemia: A five-year cohort study in Japan. Int J Cardiol. 2018; 261: 183–188.
  39. Borghi C, Desideri G. Urate-Lowering Drugs and Prevention of Cardiovascular Disease: The Emerging Role of Xanthine Oxidase Inhibition. Hypertension. 2016; 67(3): 496–498.
  40. Bove M, Cicero AF, Veronesi M, et al. An evidence-based review on urate-lowering treatments: implications for optimal treatment of chronic hyperuricemia. Vasc Health Risk Manag. 2017; 13: 23–28.
  41. Lurbe E, Torro MI, Alvarez-Pitti J, et al. Uric acid is linked to cardiometabolic risk factors in overweight and obese youths. J Hypertens. 2018; 36(9): 1840–1846.
  42. Jalal DI, Chonchol M, Chen W, et al. Uric acid as a target of therapy in CKD. Am J Kidney Dis. 2013; 61(1): 134–146.
  43. Shadick NA, Kim R, Weiss S, et al. Effect of low level lead exposure on hyperuricemia and gout among middle aged and elderly men: the normative aging study. J Rheumatol. 2000; 27(7): 1708–1712.
  44. Krishnan E, Kwoh CK, Schumacher HR, et al. Hyperuricemia and incidence of hypertension among men without metabolic syndrome. Hypertension. 2007; 49(2): 298–303.
  45. Mellen PB, Bleyer AJ, Erlinger TP, et al. Serum uric acid predicts incident hypertension in a biethnic cohort: the atherosclerosis risk in communities study. Hypertension. 2006; 48(6): 1037–1042.
  46. Grayson PC, Kim SY, LaValley M, et al. Hyperuricemia and incident hypertension: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2011; 63(1): 102–110.
  47. Bombelli M, Ronchi I, Volpe M, et al. Prognostic value of serum uric acid: new-onset in and out-of-office hypertension and long-term mortality. J Hypertens. 2014; 32(6): 1237–1244.
  48. Perlstein TS, Gumieniak O, Williams GH, et al. Uric acid and the development of hypertension: the normative aging study. Hypertension. 2006; 48(6): 1031–1036.
  49. Forman JP, Choi H, Curhan GC. Plasma uric acid level and risk for incident hypertension among men. J Am Soc Nephrol. 2007; 18(1): 287–292.
  50. Zhang W, Sun K, Yang Y, et al. Plasma uric acid and hypertension in a Chinese community: prospective study and metaanalysis. Clin Chem. 2009; 55(11): 2026–2034.
  51. Shankar A, Klein R, Klein BEK, et al. The association between serum uric acid level and long-term incidence of hypertension: Population-based cohort study. J Hum Hypertens. 2006; 20(12): 937–945.
  52. Sundström J, Sullivan L, D'Agostino RB, et al. Relations of serum uric acid to longitudinal blood pressure tracking and hypertension incidence. Hypertension. 2005; 45(1): 28–33.
  53. Bos MJ, Koudstaal PJ, Hofman A, et al. Uric acid is a risk factor for myocardial infarction and stroke: the Rotterdam study. Stroke. 2006; 37(6): 1503–1507.
  54. Tscharre M, Herman R, Rohla M, et al. Uric acid is associated with long-term adverse cardiovascular outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Atherosclerosis. 2018; 270: 173–179.
  55. Holme I, Aastveit AH, Hammar N, et al. Uric acid and risk of myocardial infarction, stroke and congestive heart failure in 417,734 men and women in the Apolipoprotein MOrtality RISk study (AMORIS). J Intern Med. 2009; 266(6): 558–570.
  56. Crosta F, Occhiuzzi U, Passalacqua G, et al. Association Between the Serum Uric Acid Levels and Lacunar Infarcts in the Elderly. J Mol Neurosci. 2018; 65(3): 385–390.
  57. Kim SY, Guevara JP, Kim KMi, et al. Hyperuricemia and risk of stroke: a systematic review and meta-analysis. Arthritis Rheum. 2009; 61(7): 885–892.
  58. Zhong C, Zhong X, Xu T, et al. Sex-Specific Relationship Between Serum Uric Acid and Risk of Stroke: A Dose-Response Meta-Analysis of Prospective Studies. J Am Heart Assoc. 2017; 6(4).
  59. Li J, Muraki I, Imano H, et al. CIRCS investigators. Serum uric acid and risk of stroke and its types: the Circulatory Risk in Communities Study (CIRCS). Hypertens Res. 2020; 43(4): 313–321.
  60. Li S, Cheng J, Cui L, et al. Cohort Study of Repeated Measurements of Serum Urate and Risk of Incident Atrial Fibrillation. J Am Heart Assoc. 2019; 8(13): e012020.
  61. Hong M, Park JW, Yang PS, et al. A mendelian randomization analysis: The causal association between serum uric acid and atrial fibrillation. Eur J Clin Invest. 2020; 50(10): e13300.
  62. Juraschek SP, Kovell LC, Miller ER, et al. Association of kidney disease with prevalent gout in the United States in 1988-1994 and 2007-2010. Semin Arthritis Rheum. 2013; 42(6): 551–561.
  63. Jing J, Kielstein JT, Schultheiss UT, et al. GCKD Study Investigators. Prevalence and correlates of gout in a large cohort of patients with chronic kidney disease: the German Chronic Kidney Disease (GCKD) study. Nephrol Dial Transplant. 2015; 30(4): 613–621.
  64. Johnson RJ, Nakagawa T, Jalal D, et al. Uric acid and chronic kidney disease: which is chasing which? Nephrol Dial Transplant. 2013; 28(9): 2221–2228.
  65. Hsu Cy, Iribarren C, McCulloch CE, et al. Risk factors for end-stage renal disease: 25-year follow-up. Arch Intern Med. 2009; 169(4): 342–350.
  66. Myllymäki J, Honkanen T, Syrjänen J, et al. Uric acid correlates with the severity of histopathological parameters in IgA nephropathy. Nephrol Dial Transplant. 2005; 20(1): 89–95.
  67. Liu P, Chen Y, Wang B, et al. Allopurinol treatment improves renal function in patients with type 2 diabetes and asymptomatic hyperuricemia: 3-year randomized parallel-controlled study. Clin Endocrinol (Oxf). 2015; 83(4): 475–482.
  68. Hart A, Jackson S, Kasiske BL, et al. Uric acid and allograft loss from interstitial fibrosis/tubular atrophy: post hoc analysis from the angiotensin II blockade in chronic allograft nephropathy trial. Transplantation. 2014; 97(10): 1066–1071.
  69. Bellomo G, Venanzi S, Verdura C, et al. Association of uric acid with change in kidney function in healthy normotensive individuals. Am J Kidney Dis. 2010; 56(2): 264–272.
  70. Stack AG, Hanley A, Casserly LF, et al. Independent and conjoint associations of gout and hyperuricaemia with total and cardiovascular mortality. QJM. 2013; 106(7): 647–658.
  71. Ioachimescu AG, Brennan DM, Hoar BM, et al. Serum uric acid is an independent predictor of all-cause mortality in patients at high risk of cardiovascular disease: a preventive cardiology information system (PreCIS) database cohort study. Arthritis Rheum. 2008; 58(2): 623–630.
  72. Choi HK, Curhan G. Independent impact of gout on mortality and risk for coronary heart disease. Circulation. 2007; 116(8): 894–900.
  73. Desideri G, Virdis A, Casiglia E, et al. Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension. Exploration into Uric and Cardiovascular Disease: Uric Acid Right for heArt Health (URRAH) Project, A Study Protocol for a Retrospective Observational Study. High Blood Press Cardiovasc Prev. 2018; 25(2): 197–202.
  74. Virdis A, Masi S, Casiglia E, et al. from the Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension. Identification of the Uric Acid Thresholds Predicting an Increased Total and Cardiovascular Mortality Over 20 Years. Hypertension. 2020; 75(2): 302–308.
  75. Perticone M, Tripepi G, Maio R, et al. Risk reclassification ability of uric acid for cardiovascular outcomes in essential hypertension. Int J Cardiol. 2017; 243: 473–478.
  76. Dutta A, Henley W, Pilling LC, et al. Uric acid measurement improves prediction of cardiovascular mortality in later life. J Am Geriatr Soc. 2013; 61(3): 319–326.
  77. Tscharre M, Herman R, Rohla M, et al. Uric acid is associated with long-term adverse cardiovascular outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Atherosclerosis. 2018; 270: 173–179.
  78. Zalawadiya SK, Veeranna V, Mallikethi-Reddy S, et al. Uric acid and cardiovascular disease risk reclassification: findings from NHANES III. Eur J Prev Cardiol. 2015; 22(4): 513–518.
  79. Muiesan ML, Salvetti M, Virdis A, et al. from the Working Group on Uric Acid, Cardiovascular Risk of the Italian Society of Hypertension. Serum uric acid, predicts heart failure in a large Italian cohort: search for a cut-off value the URic acid Right for heArt Health study. J Hypertens. 2021; 39(1): 62–69.
  80. Huang G, Qin J, Deng X, et al. Prognostic value of serum uric acid in patients with acute heart failure: A meta-analysis. Medicine (Baltimore). 2019; 98(8): e14525.
  81. Commissioner, Office of the “Safety Alerts for Human Medical Products — Febuxostat (Brand Name Uloric): Drug Safety Communication — FDA to Evaluate Increased Risk of Heart-related Death”. http://www.FDA.gov (November 17, 2017).
  82. Wang M, Zhang Yi, Zhang M, et al. The major cardiovascular events of febuxostat versus allopurinol in treating gout or asymptomatic hyperuricemia: a systematic review and meta-analysis. Ann Palliat Med. 2021; 10(10): 10327–10337.
  83. Zhang S, Xu T, Shi Q, et al. Cardiovascular Safety of Febuxostat and Allopurinol in Hyperuricemic Patients With or Without Gout: A Network Meta-Analysis. Front Med (Lausanne). 2021; 8: 698437.
  84. Gao L, Wang B, Pan Y, et al. Cardiovascular safety of febuxostat compared to allopurinol for the treatment of gout: A systematic and meta-analysis. Clin Cardiol. 2021; 44(7): 907–916.
  85. Ying H, Yuan H, Tang X, et al. Impact of Serum Uric Acid Lowering and Contemporary Uric Acid-Lowering Therapies on Cardiovascular Outcomes: A Systematic Review and Meta-Analysis. Front Cardiovasc Med. 2021; 8: 641062.
  86. McDonagh TA, Metra M, Adamo M, et al. ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021; 42(36): 3599–3726.
  87. White WB, Saag KG, Becker MA, et al. CARES Investigators. Cardiovascular Safety of Febuxostat or Allopurinol in Patients with Gout. N Engl J Med. 2018; 378(13): 1200–1210.
  88. World Health Organization Model List of Essential Medicines — 22nd List, 2021. Geneva: World Health Organization; 2021 (WHO/MHP/HPS/EML/2021.02). Licence: CC BY-NC-SA 3.0 IGO.
  89. Richette P, Perez-Ruiz F, Doherty M, et al. Improving cardiovascular and renal outcomes in gout: what should we target? Nat Rev Rheumatol. 2014; 10(11): 654–661.
  90. Okafor ON, Farrington K, Gorog DA. Allopurinol as a therapeutic option in cardiovascular disease. Pharmacol Ther. 2017; 172: 139–150.
  91. Pacher P, Nivorozhkin A, Szabó C. Therapeutic effects of xanthine oxidase inhibitors: renaissance half a century after the discovery of allopurinol. Pharmacol Rev. 2006; 58(1): 87–114.
  92. Wei Li, Mackenzie IS, Chen Y, et al. Impact of allopurinol use on urate concentration and cardiovascular outcome. Br J Clin Pharmacol. 2011; 71(4): 600–607.
  93. Feig DI, Kang DH, Johnson RJ, et al. Diuretic-induced hyperuricemia does not decrease cardiovascular risk. J Hypertens . 2004; 22(7): 1415–1417.
  94. Wei L, Fahey T, Struthers AD, et al. Association between allopurinol and mortality in heart failure patients: a long-term follow-up study. Int J Clin Pract. 2009; 63(9): 1327–1333.
  95. Luk AJ, Levin GP, Moore EE, et al. Allopurinol and mortality in hyperuricaemic patients. Rheumatology (Oxford). 2009; 48(7): 804–806.
  96. Dubreuil M, Zhu Y, Zhang Y, et al. Allopurinol initiation and all-cause mortality in the general population. Ann Rheum Dis. 2015; 74(7): 1368–1372.
  97. Noman A, Ang D, Ogston S, et al. Effect of high-dose allopurinol on exercise in patients with chronic stable angina: a randomised, placebo controlled crossover trial. The Lancet. 2010; 375(9732): 2161–2167.
  98. Rekhraj S, Gandy SJ, Szwejkowski BR, et al. High-dose allopurinol reduces left ventricular mass in patients with ischemic heart disease. J Am Coll Cardiol. 2013; 61(9): 926–932.
  99. Higgins P, Dawson J, Lees KR, et al. Xanthine oxidase inhibition for the treatment of cardiovascular disease: a systematic review and meta-analysis. Cardiovasc Ther. 2012; 30(4): 217–226.
  100. George J, Carr E, Davies J, et al. High-dose allopurinol improves endothelial function by profoundly reducing vascular oxidative stress and not by lowering uric acid. Circulation. 2006; 114(23): 2508–2516.
  101. Beattie CJ, Fulton RL, Higgins P, et al. Allopurinol initiation and change in blood pressure in older adults with hypertension. Hypertension. 2014; 64(5): 1102–1107.
  102. Feig DI, Soletsky B, Johnson RJ. Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension: a randomized trial. JAMA. 2008; 300(8): 924–932.
  103. Agarwal V, Hans N, Messerli FH. Effect of allopurinol on blood pressure: a systematic review and meta-analysis. J Clin Hypertens (Greenwich). 2013; 15(6): 435–442.
  104. Qu LH, Jiang H, Chen JH. Effect of uric acid-lowering therapy on blood pressure: systematic review and meta-analysis. Ann Med. 2017; 49(2): 142–156.
  105. Kostka-Jeziorny K, Uruski P, Tykarski A. Effect of allopurinol on blood pressure and aortic compliance in hypertensive patients. Blood Press. 2011; 20(2): 104–110.
  106. Khan F, George J, Wong K, et al. Allopurinol treatment reduces arterial wave reflection in stroke survivors. Cardiovasc Ther. 2008; 26(4): 247–252.
  107. MacIsaac RL, Salatzki J, Higgins P, et al. Allopurinol and Cardiovascular Outcomes in Adults With Hypertension. Hypertension. 2016; 67(3): 535–540.
  108. Thanassoulis G, Brophy JM, Richard H, et al. Gout, allopurinol use, and heart failure outcomes. Arch Intern Med. 2010; 170(15): 1358–1364.
  109. Hare JM, Mangal B, Brown J, et al. OPT-CHF Investigators. Impact of oxypurinol in patients with symptomatic heart failure. Results of the OPT-CHF study. J Am Coll Cardiol. 2008; 51(24): 2301–2309.
  110. Givertz MM, Anstrom KJ, Redfield MM, et al. NHLBI Heart Failure Clinical Research Network. Effects of Xanthine Oxidase Inhibition in Hyperuricemic Heart Failure Patients: The Xanthine Oxidase Inhibition for Hyperuricemic Heart Failure Patients (EXACT-HF) Study. Circulation. 2015; 131(20): 1763–1771.
  111. Cleland JGF, Coletta AP, Clark AL. Clinical trials update from the Heart Failure Society of America meeting: FIX-CHF-4, selective cardiac myosin activator and OPT-CHF. Eur J Heart Fail. 2006; 8(7): 764–766.
  112. Freudenberger RS, Schwarz RP, Brown J, et al. Rationale, design and organisation of an efficacy and safety study of oxypurinol added to standard therapy in patients with NYHA class III - IV congestive heart failure. Expert Opin Investig Drugs. 2004; 13(11): 1509–1516.
  113. George J, Struthers A. The OPT-CHF (Oxypurinol Therapy for Congestive Heart Failure) trial: a question of dose. J Am Coll Cardiol. 2009; 53(25): 2405.
  114. Hare JM, Mangal B, Brown J, et al. OPT-CHF Investigators. Impact of oxypurinol in patients with symptomatic heart failure. Results of the OPT-CHF study. J Am Coll Cardiol. 2008; 51(24): 2301–2309.
  115. Borghi C, Rosei EA, Bardin T, et al. Serum uric acid and the risk of cardiovascular and renal disease. J Hypertens. 2015; 33(9): 1729–41; discussion 1741.
  116. Kanji T, Gandhi M, Clase CM, et al. Urate lowering therapy to improve renal outcomes in patients with chronic kidney disease: systematic review and meta-analysis. BMC Nephrol. 2015; 16: 58.
  117. Goicoechea M, de Vinuesa SG, Verdalles U, et al. Effect of allopurinol in chronic kidney disease progression and cardiovascular risk. Clin J Am Soc Nephrol. 2010; 5(8): 1388–1393.
  118. Su X, Xu B, Yan B, et al. Effects of uric acid-lowering therapy in patients with chronic kidney disease: A meta-analysis. PLoS One. 2017; 12(11): e0187550.
  119. Sampson AL, Singer RF, Walters GD. Uric acid lowering therapies for preventing or delaying the progression of chronic kidney disease. Cochrane Database Syst Rev. 2017; 10: CD009460.
  120. Levy GD, Rashid N, Niu F, et al. Effect of urate-lowering therapies on renal disease progression in patients with hyperuricemia. J Rheumatol. 2014; 41(5): 955–962.
  121. Li Q, Li X, Kwong JSW, et al. Diagnosis and treatment for hyperuricaemia and gout: a protocol for a systematic review of clinical practice guidelines and consensus statements. BMJ Open. 2017; 7(6): e014928.
  122. Tykarski A, Filipiak KJ, Januszewicz A, et al. Zasady postępowania w nadciśnieniu tętniczym — 2019 rok. Nadcis Tętn Prakt. 2019; 5(1): 1–86.
  123. Borghi C, Domienik-Karłowicz J, Tykarski A, et al. Expert consensus for the diagnosis and treatment of patient with hyperuricemia and high cardiovascular risk: 2021 update. Cardiol J. 2021; 28(1): 1–14.
  124. Khanna D, Fitzgerald JD, Khanna PP, et al. American College of Rheumatology. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Res (Hoboken). 2012; 64(10): 1431–1446.
  125. Richette P, Doherty M, Pascual E, et al. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2017; 76(1): 29–42.
  126. Hui M, Carr A, Cameron S, et al. British Society for Rheumatology Standards, Audit and Guidelines Working Group. The British Society for Rheumatology Guideline for the Management of Gout. Rheumatology (Oxford). 2017; 56(7): e1–e20.
  127. Mach F, Baigent C, Catapano AL, et al. ESC Scientific Document Group. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020; 41(1): 111–188.
  128. Singh JA, Reddy SG, Kundukulam J. Risk factors for gout and prevention: a systematic review of the literature. Curr Opin Rheumatol. 2011; 23(2): 192–202.
  129. Jacob RA, Spinozzi GM, Simon VA, et al. Consumption of cherries lowers plasma urate in healthy women. J Nutr. 2003; 133(6): 1826–1829.
  130. Schlesinger N. Dietary factors and hyperuricaemia. Curr Pharm Des. 2005; 11(32): 4133–4138.
  131. Dalbeth N, So A. Hyperuricaemia and gout: state of the art and future perspectives. Ann Rheum Dis. 2010; 69(10): 1738–1743.
  132. https://www.whocc.no/atc_ddd_index/ (February 10, 2022).
  133. Charakterystyka Produktu Leczniczego, Milurit, tabletki 100 mg. https://leki.urpl.gov.pl/files/Milurit_tabl_100_300_allopurinol.pdf (February 10, 2022).
  134. Charakterystyka Produktu Leczniczego, Denofix, tabletki 80 mg. https://leki.urpl.gov.pl/files/48_Denofix_tabl_powl_80mg_25081.pdf (February 10, 2022).
  135. Deeks ED. Lesinurad: A Review in Hyperuricaemia of Gout. Drugs Aging. 2017; 34(5): 401–410.