Narrative Review: Peripheral Arterial Disease in Patients with Hyperuricemia and Gout

• Published in: Current rheumatology reports Vol. 25; no. 5; pp. 83 - 97
• Main Authors: Leung, Nicole, Fang, Charles, Pendse, Jay, Toprover, Michael, Pillinger, Michael H.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.05.2023
• Subjects: Gout - complications; Humans; Hyperuricemia - complications; Medicine; Medicine & Public Health; Peripheral Arterial Disease - complications; Peripheral Arterial Disease - etiology; Rheumatology; Risk Factors; Topical Collection on Crystal Arthritis; Peripheral arterial disease; Hyperuricemia; Endothelial function; Diabetes; Gout; Amputation
• ISSN: 1523-3774; 1534-6307
• DOI: 10.1007/s11926-023-01100-1

Purpose of Review To discuss what is currently known about the association and potential mechanistic interactions of hyperuricemia and gout with peripheral arterial disease (PAD). Recent Findings Gout patients are at increased risk for coronary artery disease, but less is known about their risk for PAD. Studies suggest that the presence of gout and hyperuricemia are associated with PAD independent of known established risk factors. Moreover, higher SU was found to be associated with greater odds of having PAD and was independently associated with decreased absolute claudication distance. Urate’s role in free radical formation, platelet aggregation, vascular smooth muscle proliferation, and impaired endothelial vasodilation may promote atherosclerotic progression. Summary Studies suggest that patients with hyperuricemia or gout are at higher risk for developing PAD. Evidence is stronger for the relationship between elevated SU and PAD than for gout and PAD, but more data is needed. Whether elevated SU serves as a marker or cause of PAD remains to be investigated.