Hyperuricemia and coronary heart disease mortality: a meta-analysis of prospective cohort studies

BACKGROUND Hyperuricemia may be associated with an increased risk of coronary heart disease (CHD) mortality; however, the results from prospective studies are conflicting. The objective of this study was to assess the association between hyperuricemia and risk of CHD mortality by performing a meta-analysis. METHODS Pubmed and Embase were searched for relevant prospective cohort studies published until July 2015. Studies were included only if they reported data on CHD mortality related to hyperuricemia in a general population. The pooled adjusted relative risk (RR) was calculated using a random-effects model. RESULTS A total of 14 studies involving 341 389 adults were identified. Hyperuricemia was associated with an increased risk of CHD mortality (RR: 1.14; 95 % CI: 1.06-1.23) and all-cause mortality (RR: 1.20; 95 % CI: 1.13-1.28). For each increase of 1 mg/dl of serum uric acid (SUA), the overall risks of CHD and all-cause mortality increased by 20 and 9 %, respectively. According to the gender subgroup analyses, hyperuricemia increased the risk of CHD mortality in women (RR: 1.47; 95 % CI: 1.21-1.73) compared to men (RR: 1.10; 95 % CI: 1.00-1.19). The risk of all-cause mortality was greater in women. CONCLUSIONS Hyperuricemia may modestly increase the risk of CHD and all-cause mortality. Future research is needed to determine whether urate-lowering therapy has beneficial effects for reducing CHD mortality.