Thesis (M.Sc.) - Cairo University - Faculty of Medicine- Department of Cardiology

Earlier large epidemiologic studies have reported that elevated level of serum uric acid is associated with risk of cardiovascular diseases and death.1,2 The relationships between hyperuricemia and other cardiovascular risk factors including hypertension , hyperinsulinemia, reduced physical activity, increased body mass index (BMI), and decreased high density lipoprotein cholesterol (HDL) are demonstrated in many clinical studies.3,4 Factors which are related to hyperuricemia are associated with the established risk factors for many cardiovascular diseases. The independence of uric acid association from other confounding factors has remained controversial.Although the mechanisms by which uric acid may play a pathogenetic role in cardiovascular diseases is unclear, hyperuricemia is associated with deleterious effects on endothelial function, oxidative metabolism, platelet adhesiveness, hemorheology and aggregation.6 Several lines of experimental evidence suggest that uric acid is associated with injurious effects on the vasculature and renal tissues. Studies in rats show that elevated uric acid levels following administration of an uricase inhibitor increase blood pressure as well as produce a primary arteriopathy independent of blood pressure. These effects, possibly mediated through activation of the renin angiotensin system and down regulation of nitric oxide synthase, could be ameliorated by treatment with allopurinol or benziodarone

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