When it comes to high uric acid, many people only notice the "gout" it causes, but this is just the "tip of the iceberg," beneath which lurks a comprehensive threat to the cardiovascular and cerebrovascular systems. How does it start from the joints and quietly affect our heart and brain?
Hyperuricemia is often regarded as a hallmark of gout, but its harm extends far beyond the joints. Typically, a persistent blood uric acid level exceeding 7.0 mg/dL can be diagnosed as hyperuricemia. Previous studies have shown that hyperuricemia is an independent risk factor for cardiovascular and cerebrovascular diseases, increasing the risk of such conditions.
The damage of hyperuricemia to the cardiovascular and cerebrovascular systems is primarily based on two mechanisms. On one hand, when uric acid becomes supersaturated in the blood, it can form urate crystals and deposit on the vascular walls, directly stimulating the vascular endothelium, triggering inflammatory responses and oxidative stress, damaging the integrity of the vascular endothelium, and promoting lipid deposition, gradually leading to the formation of atherosclerotic plaques.
On the other hand, high uric acid inhibits the production of nitric oxide, a key vasodilator, leading to vasoconstriction; it activates the renin-angiotensin system, prompting the kidneys to increase sodium reabsorption, further causing elevated blood pressure. High uric acid and hypertension are mutually causative, forming a vicious cycle that can significantly increase the burden on the cardiovascular and cerebrovascular systems. Consequently, high uric acid may induce the following types of cardiovascular and cerebrovascular diseases.
Inducing three types of heart disease
First, arrhythmia. Elevated uric acid levels can interfere with the normal electrophysiological activity of the heart by triggering inflammatory responses and oxidative stress, particularly increasing the risk of atrial fibrillation. Second, myocardial infarction. Uric acid crystals can promote the formation of arterial plaques, while high uric acid levels also make plaques unstable, increasing the risk of heart attack. Third, heart failure. Long-term hypertension and coronary atherosclerosis can increase the burden on the heart, leading to myocardial hypertrophy and fibrosis; high uric acid has a direct toxic effect on myocardial cells. These factors can all lead to a decline in the heart's pumping function, ultimately progressing to heart failure.
Increased risk of stroke
Hyperuricemia-induced atherosclerosis can also affect the carotid and intracranial arteries, leading to cerebral infarction. Meanwhile, hyperuricemia-related hypertension is the most significant risk factor for cerebral hemorrhage.
Impair cognitive function
Uric acid plays a dual role in brain health within the physiological range it may have a neuroprotective effect as an antioxidant however when its levels are too high its proinflammatory and vascular damaging effects become dominant exacerbating neuroinflammation and promoting betaamyloid deposition thereby driving the progression of Alzheimers disease additionally high uric acidinduced cerebral small vessel disease can also impair cognitive function
In daily life, managing uric acid levels is advised by "watching your diet and staying active." Ensure a diverse diet and adequate water intake, but try to avoid consuming animal organs, seafood-rich broths, hot pot soup bases, and the like. Limit high-fat and high-salt foods, avoid alcohol and sugary beverages. Schedule at least 150 minutes of moderate-intensity aerobic exercise per week, such as brisk walking, jogging, swimming, etc. Maintain a regular routine and keep your weight under control.
