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Serum Uric Acid and Risk for Cardiovascular Disease and Death: The Framingham Heart Study

Bruce F. Culleton, MD; Martin G. Larson, ScD; William B. Kannel, MD; and Daniel Levy, MD
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From the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts; and Boston University School of Medicine, Boston, Massachusetts.


Grant Support: The Framingham Heart Study is supported by National Institutes of Health/National Heart, Lung, and Blood Institute contract N01-HC-38038. This investigation was supported in part by a research grant from Merck and Co., Inc. Dr. Culleton is a recipient of the 1997-1999 Kidney Foundation of Canada Fellowship.

Requests for Reprints: Daniel Levy, MD, Framingham Heart Study, 5 Thurber Street, Framingham, MA 01702; e-mail, Dan@fram.nhlbi.nih.gov.

Current Author Addresses: Dr. Culleton: Division of Nephrology, University of Calgary, Foothills Hospital, Room C-210, 1403 29th Street, Calgary, Alberta T2N 2T9, Canada.

Drs. Larson, Kannel, and Levy: Framingham Heart Study, 5 Thurber Street, Framingham, MA 01702.


Ann Intern Med. 1999;131(1):7-13. doi:10.7326/0003-4819-131-1-199907060-00003
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The association of serum uric acid with cardiovascular disease has been appreciated for nearly half a century (1). Several prospective studies have shown an association between baseline hyperuricemia and incident coronary heart disease, cardiovascular disease, and death (210). Despite the strength of these associations, uric acid has not been established as a causal risk factor for cardiovascular disease. Instead, uric acid seems inextricably linked to hypertension, dyslipidemia, and disordered glucose metabolism, which play a causal role in the pathogenesis of cardiovascular disease. As such, uric acid may be merely a marker of risk for cardiovascular disease.

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Grahic Jump Location
Figure.
Mean serum uric acid level by sex and 5-year age group.

Solid line represents men; dashed line represents women; squares represent values at midpoint of 5-year age group; and vertical bars represent 95% CIs.

Grahic Jump Location

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