Adults with hyperuricemia or gout are more likely to have heart failure and to die early, a new study confirms.

In a nationally representative sample of the US population, patients with hyperuricemia (serum uric acid of 6 mg/dL in women and 7 mg/dL in men or more) or diagnosed gout had significant 2.5- and 2.4-fold increased odds of heart failure compared with those without either condition in adjusted analyses, Xuejun Zeng, MD, PhD, of Peking Union Medical College Hospital in Beijing, China, and colleagues reported in the Journal of Translational Medicine. They also had 1.4 and 1.5-fold increased risks of all-cause mortality and 5.4- and 5.2-fold increased odds of cardiovascular mortality. As serum uric acid increased, the risk of heart failure increased nonlinearly. The risk between serum uric acid and all-cause mortality followed a J-shaped curve.

The study findings were based on data from the 2001–2018 and 2007–2018 National Health and Nutrition Examination Surveys. Among the 204,179,060 and 223,702,171 adults in these survey periods, 40,044,228 (19.6%) and 9,158,600 (4.1%) had hyperuricemia and gout, respectively. Heart failure risk factors in these cohorts included older age, diabetes, stroke, and coronary artery disease.

Continue Reading

“[Serum uric acid] exerts many deleterious effects on cells, and thus it may be directly involved in the pathophysiology of [cardiovascular disease],” according to Dr Zeng’s team. “The depletion of nitric oxide and endothelial dysfunction, promotion of local inflammation and pro-oxidant activity, increased oxidative stress, and potentiation of vasoconstrictor and proliferative vascular stimuli are the most accepted pathophysiological mechanisms of [serum uric acid] involvement in the development of [cardiovascular disease].” Advanced education was protective against heart failure, the investigators reported.

The median survival time was 7.00 years and 6.25 years for patients with hyperuricemia and gout and concurrent heart failure, respectively. The 5-year survival rate was 59.9% and 55.9%, respectively. Patients with hyperuricemia had higher rates of smoking.


Han Y, Cao Y, Han X, et al. Hyperuricemia and gout increased the risk of long-term mortality in patients with heart failure: insights from the National Health and Nutrition Examination Survey. J Transl Med. 2023 Jul 12;21(1):463. doi:10.1186/s12967-023-04307-z