TỔNG QUAN VỀ MỐI LIÊN QUAN GIỮA TĂNG ACID URIC MÁU VÀ KẾT CỤC BẤT LỢI Ở BỆNH NHÂN MẮC BỆNH TIM MẠCH

Abstract

Background: Cardiovascular diseases (CVDs) remain the leading cause of death worldwide, and the role of serum uric acid has increasingly attracted attention as a potential risk factor. Objectives: This narrative review aims to synthesize and analyze current evidence regarding the association between hyperuricemia and adverse cardiovascular outcomes. Materials and methods: This narrative review summarizes and analyzes eight representative studies published between 2009 and 2025, retrieved from PubMed, Google Scholar, and Web of Science, including meta-analyses, large cohort studies, and randomized controlled trials. Results: The evidence indicates a positive association between elevated UA levels and increased cardiovascular events and mortality. Each 1 mg/dL increase in UA is associated with a 6–12% higher risk of cardiovascular events, with concentrations ≥6 mg/dL considered a warning threshold. Proposed pathophysiological mechanisms include nitric oxide reduction, renin–angiotensin system activation, and oxidative stress–induced vascular inflammation. A meta-analysis of 26 clinical trials demonstrated that allopurinol reduced the composite risk of cardiovascular events by 35% (RR=0.65; p=0.012), particularly at doses ≥300 mg/day. Conclusion: Hyperuricemia is an independent and modifiable cardiovascular risk factor. Controlling serum UA levels may improve cardiovascular prognosis; however, large-scale clinical trials are warranted to determine its preventive value and optimal therapeutic threshold.