ACIDO URICO E MALATTIE CARDIOVASCOLARI. L’ESPERIENZA DELLO STUDIO URRAH.

The relationship between uric acid and cardiovascular disease is a tool of great scientific interest. Although high levels of uric acid are frequently associated with atherosclerosis and its clinical complications, there are still several points where greater clarity is needed, starting from the threshold levels beyond which cardiovascular risk increases. It is still uncertain whether uric acid can cause direct vascular damage or whether uric acid is only a marker of potentially harmful metabolic disorders. On these bases, the URRAH study was designed, through the creation of a database of epidemiological and clinical studies, on a multicentre basis, distributed throughout the country, with homogeneous data that had to include at least one determination of uric acid levels, complete information on demographic, anthropometric, metabolic and clinical data and be designed with a follow-up of at least 10 years, evaluating mortality and cardiovascular events. This article summarizes the main results obtained so far on various aspects, from the evaluation of threshold levels of uric acid for the prediction of the risk of events and the relationships with some conditions able to modulate levels of uric acid and cardiovascular risk, such as kidney disease, cardiac function, metabolic disorders and plasma lipids. The URRAH Study is contributing significantly to a clearer understanding of the role of uric acid in atherosclerotic disease and in the prediction of cardiovascular risk.