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Hyperuricemia is a condition of high blood uric acid levels that may be a risk factor for the development of serious cardiovascular disease. It is estimated that as many as 10 million Poles may struggle with this problem. The key to tackling hyperuricemia is regularly measuring uric acid levels in your blood. From 1 July to 31 December, as part of the “Prevention 40+” program, everyone aged 40 and over will be able to take advantage of the free diagnostic test package, which includes uric acid level testing.
Hyperuricemia – what is it and how does it arise?
Too high levels of uric acid, or hyperuricemia, increase the risk of heart and vascular disease. This relationship is mutual. Conditions that affect the cardiovascular system can in turn cause elevated levels of uric acid. Little is still said about this vicious circle mechanism. And the problem is more serious than it might seem, because it is estimated that it affects about 10 million Poles, i.e. almost every 4th of us. In Europe, this number exceeds 27 million.
It is estimated that hyperuricemia affects:
- 50 percent suffering from hypertension (about 5 million people),
- 40 percent patients with diabetes (approx. 3 million people),
- 40 percent people with abdominal obesity and 70 percent. people with metabolic syndrome.
Untreated or improperly controlled hyperuricemia contributes not only to the development of gout, but also promotes the formation of atherosclerotic lesions, chronic inflammation of the vessels and can lead to serious damage to them. It is one of the reasons for the development of arterial hypertension, and the risk even doubles over a 5-year period. Moreover, complications of hyperuricemia and accompanying cardiovascular diseases may include stroke and heart attack, i.e. conditions that directly threaten human life.
The disease may develop completely asymptomatically, the patient then does not feel any disturbing symptoms and does not seek help from a doctor. Unfortunately, very often elevated levels of uric acid are discovered too late, when the patient is admitted to the hospital with complications, such as a heart attack, stroke, severe hypertension or advanced diabetes.
The biggest problem in the diagnosis and treatment of hyperuricemia, both by patients and clinicians, is the lack of awareness of what uric acid levels require attention. So far, hyperuricemia has been defined as uric acid levels above 7 mg / dl, because in rheumatology, in the case of gout, uric acid crystals crystallize, i.e. precipitate. It causes inflammation, i.e. an attack of gout, inflammation of the joints. However, studies show that lower uric acid levels (between 5 mg / dL and 7 mg / dL) may also be associated with increased cardiovascular risk. With normal kidney function, they are a signal that there is an increased synthesis of uric acid and thus the formation of free radicals, deterioration of endothelial function, especially in people with high cardiovascular risk, and thus cardiovascular events. Even moderately elevated uric acid levels should be monitored and, in certain cases, treated, argues prof. Andrzej Tykarski from the Medical University of Karol Marcinkowski in Poznań, head of the Department and Clinic of Hypertensiology, Angiology and Internal Medicine.
Get regular check-ups – check uric acid levels
It is worth adding uric acid concentration to the calendar of regular diagnostic tests. In the near future, the availability of the study for patients will increase significantly in connection with the “Prevention 40+” program, which is to be launched on July 1 and last until the end of the year. Anyone 40 years old or older will be able to get one-time access to a free diagnostic test package with 6 to 12 types of tests, including uric acid testing.
It is recommended to check this parameter at least once a year. Doctors emphasize, however, that the first uric acid level test should be performed before the age of 40. The exceptions are people who, due to their genetic burden, are more prone to diseases of the cardiovascular system. Then the concentration of uric acid should be checked at the age of about 30 years.
The risk of hyperuricemia increases with age. For gentlemen, this risk appears earlier. In women, due to the presence of estrogens, a little later. Obesity and eating too much meat are also conducive to elevated uric acid levels. Nevertheless, the most important thing is whether the body produces excess uric acid endogenously, i.e. inside the body. Because it causes additional formation of free radicals, explains Prof. Andrzej Tykarski.
What result should be worrying? The cut-off point is 5 mg / dL. Such uric acid levels increase the risk of vascular endothelial inflammation and, consequently, can lead to the development of a number of diseases, including:
- arterial hypertension,
- metabolic syndrome,
- atherosclerosis,
- coronary syndromes and heart failure,
- stroke
- chronic kidney disease.
In patients with other risk factors, especially hypertension and hypercholesterolaemia, uric acid levels should be additionally tested. This is to exclude the additional influence of this factor contributing to the formation of cardiovascular events – argues prof. Andrzej Tykarski.
Early detection reduces the risk of complications
What are the benefits of early detection of hyperuricemia? Above all, it is a chance to quickly take appropriate preventive or strictly therapeutic steps. If uric acid levels are slightly elevated, most often it is enough to make some adjustments to the daily diet, as well as increase physical activity. People with hyperuricemia should follow a low-purine and low-fructose diet. This means significantly reducing or eliminating meat, meat offal and seafood (containing purines), as well as sugary drinks, and eliminating alcohol. The daily menu should include fresh vegetables, whole grains, eggs and low-fat dairy products. Adequate hydration is also necessary – up to 3 liters of water a day.
However, it is worth remembering that even a very restrictive diet allows you to reduce uric acid by about 10-15 percent. This may not be enough. Therefore, it is often necessary to implement appropriate pharmacotherapy. Treatment must take place under the constant supervision of a physician, the doses of the drug should be selected according to the current blood test results, as well as the general health of the patient. You must not modify the type or dose of drugs on your own. It is also a mistake to stop therapy, which is unfortunately a common problem in treating patients with chronic diseases, mainly in the time of the COVID-19 pandemic. Controlling hyperuricemia reduces the risk of developing serious complications, mainly cardiovascular diseases and their health and life-threatening consequences.
Hyperuricemia in the COVID-19 pandemic
It cannot be denied that the global COVID-2020 pandemic that has been taking place since March 19 hinders the diagnosis and treatment of chronic diseases. Many patients are unable to benefit from medical appointments, which have replaced telepaths, and thus do not undergo preventive examinations. Unfortunately, the effect of the lack of regular examinations may be felt for months and years to come. The lack of appropriate prophylaxis increases the risk of delaying the implementation of effective treatment and extends the time and, above all, reduces the chance of complete recovery. It is no different in the case of hyperuricemia.
The trouble is, the availability of doctors is obviously less during a pandemic. Hyperuricemia is difficult to detect if these are only teleportation visits, without laboratory tests being requested. On the other hand, the mere fact of passing the SARS-CoV-2 virus infection is irrelevant in the context of treatment. These patients can be treated just like people who have not had COVID-19. It is worth emphasizing, however, that COVID-19 is also a disease of the vascular endothelium, as is elevated uric acid concentration. Therefore, between the history of COVID-19 and hyperuricemia, there may be an unfavorable synergy in this regard, says Prof. Andrzej Tykarski.
Worth knowing
- Every 1 mg / dl increase in blood uric acid concentration increases the risk of mortality in patients with cardiovascular problems by 39%. (PreCIS study).
- Already a few weeks after the increase in uric acid concentration in the blood, arterial hypertension may develop. On a 5-year scale, the risk of developing this disease even doubles.
- Mortality from heart disease in patients with hyperuricemia is more than 2 times higher compared to people with normal blood uric acid levels (MONICA clinical studies).