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This issue has arisen from discussion on the Gout and Red Wine thread.
https://gout-pal.com/gout-p…..e-2/#p3120
It's got legs, as they say, and is getting quite 'in-depth'.
Zip has posted 2 interesting links on the research:
A study in the CONGO reported in the INTERNATIONAL JOURNAL OF CARDIOLOGY:
&
Hyperuricemia and Incident Heart Failure Eswar KrishnanStanford University, Stanford, CA
and my last response is repeated here:
One report specifically refers to African subjects, Zip! This population are known to have substantial CV risk variances c.f. to white populations.
The latter report is more persuasive, for the general population, – until it flags the lowest quartile as <3.4 SUA *** , a level that only exists in younger women and pre-pubescent boys, notably.
This report starts off by saying the broader population has not previously been studied for risk – if this 2:1 hazard factor conluded is hidden behind the extraction from the 11 variables stated that triple that risk to 6:1 I would suggest that the report could be misleading ,statistically.
I'm not qualified to check the raw results, even if they were available. [Must be a huge database]
I just stress that many other studies keep noting these trends and risk factors but haven't yet come to a consensus on a solid link.
*** Broadly, they are not comparing 'like with like' -specifically across the age and gender spectrum even though they claim they account for it. The figures are pre- loaded and say to me:
Sure! Older males get gout- and can suffer CV complications 6X as much than 36 y.o's-
BUT… what about their GENETIC based predisiposition to METABOLIC disorders themselves causing this ?
This could be an ignored variable -and an independant precursor for both Gout and CV disease.
So, I agree the CV risk co-factors exist and broadly would not wish high SUA on anyone, but these reports don't give a persuasive cross population result. They're partial , and thus flawed!
Modern research isn't all it appears. I won't go into reasons for thinking that , right here.
I'm more interested in your response to my view on these reports.
On this reposting I'm adding this conclusion from the second report
“Hyperuricemia is a novel, independent, risk factor for heart failure in a group of young general community dwellers.”
This doesn't to be reflected in the text analysis.
Sorry, I've been changed to RED and it won't change back!!
From trev: I just stress that many other studies keep noting these trends and risk factors but haven't yet come to a consensus on a solid link.
The evidence for the hyperuricemia-CVD link is there and it is solid evidence limited ONLY by the ability of schools and clinincs to fund the research and I could post page after page after of data supporting the strong connection but I am reminded of the pretty sollid evidence that existed iin the 50's that ciigarettes were deadly…we called them COFFIN NAILS as far back as my memory goes. But decade after decade passed during which the cigarette producers (aka cancer, heart disease, COPD, emphysema producers) kept saying “Yes but there's not enough evidence linking smoking with these disease. THere's no CONSENSUS.” And of course the oil companies claim no scientific CONSENSUS on global warming until the only glacier will be available as pictures in old Nation Geographic magazines.
I am not impressed by statements like “Yah, but that's only for women” or “Yah but that's only for blacks” or “Yah, but that's only for the elderly.” In my book that is obfuscation. Neither am I very impressed by advantages of uric acid that are demonstrable only in vitro (in a test tube or a petri dish.) But I am least impressed by claims that uric acid is somehow “an antioxidant” along with every other peddleable expensive nutritional supplement.
Remember, there is a financial penalty to be paid if hyperuricemia is llinked to diseases other than gout, especially heart disease and brain damage. And that is because the FIRST dietary promulagation, once the clear link is actually ADMITTED will be to eat far less meat and fish. The screams from the meat and fish producers will make Phillip Morrris' howling of the last 30 years sound like a cat's purr by comparison.
trev, I'm glad you started a new page on this. I was feeling guilty for cluttering up the other thread. Now we have a clear place to present the evidence on the proposition/debate: Resolved: “Hyperuricemia is a killer independent of gout. Yea or Nay”…or it's corollary: “Average levels of uric acid are beneficial to humans…Yea o Nay”
My position is prettyy stongly AYE, hypreuricemia is causative in heart disease and NAY, it is a poison and has no meaningfully useful function for humans. I think the evidence supports both these positions.
Ancillary,
Yes, I understand being stuck with that red color because sometimes this board has a mind of its own on formatting…once it gets a font or a color in its head there no doing anything about it. I've given up trying to battle it except for that occasssionally teeny font that occasionallly pops up on cut and pastes that is impossible to read without a strong magniffying gllass. Sometimes I just give up trying to do the paste because nobody will be ablle to read it.
{{wink}} I guess you are leaving it to me to do that dogwork in digging out those two Italian studies…I was hoping to pass the baton on that one.
Well, Zip- you seem to accept my reservations on this analysis.
I understand your preference to see gender,race and age as obscurants because that is exactly what they are!
Unfortunately, these variables- in such a deeply hidden processes in the human body, are where the research is needed.
I'm pretty well vegetarian anyway, so don't mind reducing what I don't do anyway 🙂 -but I think you're right about 'vested interests' affecting the direction of research in broad terms.
If you are specifically right over Gout, and moreso CV disease connection with simple hyperSUA, than that would help explain why there is a readily agreed [here at least] feeling that the medical world is not keen on really pinning down the causes of gout – only in managing and relieving the results of longterm neglect.
I think the term is Denial?
Many Gov't programs exist to educate about the dangers of smoking, obesity and alcohol abuse [though they all raise tax revenue…] but little about our 'special interest' – SUA !
I suppose- that is as we're on a Elder, Male and genetically compromised short list- but not for Parliament… where we could have an efect !
[see recent UK Tory 'all female short lists' for the coming election]
DON'T hold your breath
PS: Any new data will help push the debate along! We may not get a load of company, however!
I'm missing these debates, but I've just got to get that GoutPal.com site moved this weekend – then I'll be back to more frequent commenting (after another 3 weeks “bedding in”)
So a quick comment on this one. And apologies if it has already been said, cos I've got some catching up to do.
The important issue here is risk.
Everything I have read points to a strong statistical link between uric acid and cardio-vascular problems, but nobody has come up with an explanation of that link.
What that means to me in practical terms is that anyone with raised uric acid level should arrange for cardio-vascular tests. That way, if your higher risk turns into an actual problem, it gets nipped in the bud.
On the 'uric acid good for humans' front, the only sensible theory I have seen is that it is linked with the human penchant for walking upright. It is assumed by many that the presence of uric acid raises blood pressure, allowing blood to reach the brain better. For myself, I'd be quite happy to live life on all fours (occasioanl all-fives?) and do without the uric acid.
If I've missed something important on this, or any other topic, please can someone Private Message me with a link.
On the research angle- it doesn't seem like much is happening- but we won't know until it's published!! Genetics seem a good angle- and I must pursue the line a bit further.
On the latter point..
I know Zip may crank up on this- but in the back of my mind is:
Antioxidants stopping free radical damage to artery walls that would normally be repared by chloresterol deposits- which would then hasten high BP and arterial sclerosis.
This is something that GP has mentioned a while back in rough detail- and I thought there could be something it, at the time.
Here's my vision on the CVD-hyperuricemia connection:
Just like deposition into ligaments , joints and kidneys, urate can crystallize onto and INTO an artery wall. THe body perceives the antigen and attacks with phagocytosis…the artery tries to protect itself from this inflammatory battle and end the attack by covering over the whole magilla it with a waxy fat hiigh in LDL choleserol. Autopsy has shown arterial plaques to be composed of fats, cholesterol, pus and urate.
I saw a foot autopsy picture and bejesus it looked like the tophus in the toe was covered in the same whitish-yellowish layer of what looked very similar to coronary arterial plaque.
So the protective device in the toe becomes the killer in a coronary artery…or ANY artery. When one of these infected plaques break in the foot we get a gout attack, when it breaks in an important artery we risk a lung or kidney embolism, an attack of phlebitis, a heart attack, or an occusive stroke.
Why would one expect uric acid to cause an inflammatory process in ONE part of the body and PREVENT an inflammmatory response in another? The immune system HATES uric acid because it is a poison and it hates it WHEREVER it finds it and the reaction/overraction of the immune system causes gout and abets heart disease.
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