Elevated uric acid levels and the association with heart disease
Elevated Uric Acid Levels and the Association with Heart Disease
Uric acid, a waste product found in the blood, is created when your body breaks down chemicals called purines. When uric acid levels get too high it often leads to a condition known as hyperuricemia. If left untreated, elevated uric acid levels can eventually lead to many health problems including heart disease, gout and kidney disease. (1)
High Uric Acid
What are the symptoms of high uric acid levels?
Most symptoms of elevated uric acid levels occur suddenly and without prior warning.These may include:
- Intense joint pain
- Inflammation and redness
- Shiny, discoloured skin around the joints
- Back pain
- Frequent urination
- Limited range of motion
Causes of high uric acid levels
It’s often difficult to determine exactly what causes high uric acid levels in the blood (hyperuricemia). But, research shows that environmental factors and genetics play a major part.
Common risk factors include:
- High blood pressure
- A high-purine diet
- A high fructose diet
- Regular alcohol consumption
- Metabolic syndrome
What is an alarming level of uric acid?
Elevated uric acid levels could be the sign of a more serious underlying medical condition or simply because your diet is too high in foods containing lots of purine.
- For males, above 7 mg/dL
- For females, above 6 mg/dL
Dr David Perlmutter in his ground breaking book ‘ Drop Acid – The surprising new science of uric acid’ says that his evaluation of research has shown that these levels are too high and people should aim for levels of uric acid below 5.5mg/dL to reduce cardiovascular risk. Dr Perlmutter’s book is an essential read for everyone looking to improve heart health and reduce the risks of metabolic syndrome.
Can high uric acid cause heart problems?
Elevated levels of uric acid have been associated with a significant increase in the risk of hypertension and cardiovascular disease (CVD) because it contributes towards endothelial dysfunction by impairing nitric oxide production. Also, it is thought that high uric acid levels cause inflammation that may eventually lead to heart failure. (4)
A study published recently in 2021 in AHA Journals investigating the relationship between uric acid trajectories and the rate of CVD for over 20 years in a population of more than 3000 young adults found that high-increasing serum UA (uric acid) pattern trajectory during adulthood is associated with incident CVD later in life with a major impact on blood pressure during the exposure period. (5)
Furthermore, a study published in ECR (European Cardiology Review) showed clear evidence that hyperuricaemia is associated with a greater risk of target organ damage and of cardiovascular morbidity and mortality. The increase in risk was also found to be stronger in patients with high cardiovascular risk and in patients with uric acid levels greater than 6 mg/dL. (6).
Elevated Uric Acid Levels
Is there a connection between gout and heart disease?
Research often links gout to an increased risk of several types of cardiovascular disease, including heart attack, atrial fibrillation, irregular heartbeat and total heart failure. It is also thought that gout increases the risk of strokes and peripheral vascular disease. (7,8)
A study carried out by Arthritis Care & Research found that adults 65 and over suffering from gout have at least double the risk of getting a heart attack compared with those without gout. (9)
According to new research, gout a type of inflammatory arthritis may also worsen heart-related outcomes for people being treated for coronary artery disease.
A study published in The Journal of the American Heart Association sought to clarify older research on the link between cardiovascular disease and gout, which occurs in people with high uric acid levels in the blood.
Among patients who had gout at the beginning of the study or who developed it during follow-up, their risk of either dying of cardiovascular disease or having a heart attack or stroke was 15 per cent higher than patients who never developed gout.
What other conditions can develop with elevated uric acid?When high uric acid levels are left untreated it may eventually lead to many other health conditions.
Kidney diseaseUric acid crystals form kidney stones in some people which are very painful and can block the kidneys from removing waste causing infection. The kidneys may also experience scarring from the stone’s sharp edges potentially leading to CKD (chronic kidney disease) and at worst, kidney failure. (10)
Type 2 diabetesSome large-scale studies, including the Framingham Heart Study, which followed several thousand people over many years, have found that patients with high uric acid levels have a higher chance of developing type 2 diabetes as well as metabolic syndrome. This is especially true for women.
Fatty liver diseaseElevated serum uric acid (UA) levels strongly reflect and may even cause oxidative stress, insulin resistance, and metabolic syndrome, which are risk factors for the progression of liver disease. (11,12)
5 natural ways to reduce uric acid in the body
1. Stay hydratedDrinking plenty of fluids helps your kidneys flush out uric acid faster. Keep a water bottle with you at all times. Set an alarm every hour to remind you to take a few sips. Best to drink filtered water with good structure so that it is better absorbed in the body.
2. Limit purine-rich foodsTry to limit purine-rich foods which give off uric acid when they're digested. These foods include:
- Organ meats
3. Avoid refined sugar
As your body breaks down fructose (natural sugar) it releases purines and increases uric acid levels. Try to avoid sugary foods high in sugar such as corn syrup, table sugar, sweet beverages, and high fructose corn syrup. According to Dr Perlmutter, fructose in its many forms and guises is a major contributor to elevated uric acid levels and should be limited.
Eating more whole foods by limiting the amount of processed and packaged foods you buy is a great way of limiting refined sugar intake. And if you do feel a sugar craving try eating a piece of fresh fruit.
4. Add in more fibreFibre helps your body balance blood sugar and insulin levels. It also tends to increase satiety, helping to lower the risk of overeating.
5. Reduce alcohol consumptionAlcohol, especially beer, contains a high purine content which easily increases purine production in the body. Alcohol also affects the rate of uric acid secretion and increases the metabolism of nucleotides, another source of purines that can be turned into uric acid.
According to Dr Perlmutter’s research careful supplementation can be helpful and he highlights the following supplements as being particularly beneficial to reduce uric acid levels.
- Quercetin 500mg per day
- Luteolin 100mg per day
- DHA 1,000mg per day
- Vitamin C 500mg per day
- Chlorella 1,200mg per day.
Dr Perlmutter does suggest adding broccoli sprouts to our diet because it is a precursor to a powerful molecule that produces sulforaphane which helps to control uric acid levels, in addition to giving many other health benefits. He also believes in the power of tart cherries. He favours eating the cherries rather than consuming cherry juice because of the high sugar content of many juices.
Diet and lifestyle play a major role in how much uric acid your blood contains
Diet and lifestyle play a major role in how much uric acid your blood contains. Elevated levels are harmful to our well-being and may potentially cause a wide range of health complications — especially heart-related conditions.
Diet, exercise, and other healthy lifestyle changes can help improve gout and other illnesses caused by high uric acid levels. Limiting purine-rich foods, supplementing carefully and staying hydrated are good ways to keep your uric acid levels low.
Written by Kieran Higgins, Health Writer.
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