Uric acid: an old actor for a new role.

The role of uric acid as an independent risk factor for cardiovascular events is still debated. In fact, other confounding factors such as glucose intolerance, obesity, dyslipidaemia, hypertension, use of diuretics and insulin resistance may play a role in determining the increased vascular risk associated to elevated uric acid concentrations. These factors (including high uric acid) have been mentioned in one or more definitions of the metabolic syndrome. Recently, much attention has been paid to the metabolic syndrome due to its possible role as a risk factor for the development of type 2 diabetes and cardiovascular disease. The worldwide increase in the prevalence of obesity and diabetes is a reason not only for the increasing prevalence of the metabolic syndrome but also of hyperuricaemia. A better understanding of the role of uric acid in health and in disease states may help physicians to improve their performance in preventing and treating cardiovascular disease.