Expert consensus for the diagnosis and treatment of patients with hyperuricemia and high cardiovascular risk: 2025 update

作者：Richard Johnson, Ivan Gruev, Y. Yotov, Peter Jackuliak, Claudio Borghi, Justyna Domienik-Karłowicz, Andrzej Tykarski, Krzysztof J. Filipiak, Milosz J. Jaguszewski, Krzysztof Narkiewicz, Marcin Barylski, Artur Mamcarz, Jacek Wolf, Zoltán Járai, David Becer, Michal Vrablı́k, Dragoș Vinereanu, Marcin Wełnicki, Krystyna Widecka, Mieczyslaw Litwin · 发表于：European Journal of Internal Medicine · 年份：2026 · DOI：10.1016/j.ejim.2026.106727 · 被引用次数：8 · 研究领域：Gout, Hyperuricemia, Uric Acid、Diet, Metabolism, and Disease、Sodium Intake and Health

BACKGROUND: Hyperuricemia has traditionally been viewed primarily as a cause of gout; however, accumulating evidence indicates that elevated serum uric acid (sUA) is also associated with increased cardiovascular and renal risk. Recent epidemiological studies suggest that adverse outcomes may occur at sUA levels well below the classic crystal-based thresholds, particularly in patients with high cardiovascular risk. METHODS: This expert consensus document was developed by a multidisciplinary European panel of cardiology, internal medicine, nephrology, and hypertension specialists. The recommendations are based on a critical narrative review of the literature published, including large cohort studies, meta-analyses, randomized controlled trials, and contemporary European guidelines (ESC, ESH, KDIGO, EULAR). Particular emphasis was placed on outcome-driven serum urate thresholds and clinically applicable risk stratification. RESULTS: Hyperuricemia is common and increasingly prevalent, especially among individuals with hypertension, chronic kidney disease, obesity, diabetes, and established cardiovascular disease. Elevated sUA is independently associated with cardiovascular mortality, heart failure, stroke, and faster progression of chronic kidney disease. However, randomized trials have not shown clear cardiovascular or renal benefit from routine urate-lowering therapy in patients with asymptomatic hyperuricemia. Based on current evidence, this consensus proposes a risk-based, in...