Abstract
Over the last decades several studies among the adult population have attempted to establish a correlation between the risk of stroke incidence and serum uric acid (SUA) concentration, and how these levels influence the patient’s neurological outcome after a stroke. But, to date, the results are conflicting. In this review, an extensive literature search was performed through PubMed for articles published until May 2019 to review the association. The study selection was narrowed by searching PubMed database using the Medical Subject Headings (MesH) and associated keywords. Only articles conducted in English and on human subjects were included. We considered an article for this review if it had statistics on either the incidence, stroke mortality or post-stroke functional outcomes along with serum uric acid levels in adults.This review includes 21 articles with data of 33,580 cases of stroke and 1,100,888 participants. We can divide the articles reviewed into two separate cohorts of studies. One relates serum uric acid levels to stroke frequency and mortality, while the other is associated with serum uric acid and outcomes for stroke survivors. Based on our review, no significant relationship is observed with uric acid exhibiting protective effects on stroke outcome. Large clinical trials are advised to provide well-defined solutions to further assess the benefits of uric acid level lowering treatment in patients of vascular events, such as a stroke. However, we confidently report that increasing uric acid levels poses a higher risk for incidence of stroke.
Highlights
BackgroundStroke is the fifth most prevalent cause of death in the United States with an annual reported figure of 142,000 deaths while 795,000 individuals experience a new or recurrent stroke
We considered an article for this review if it had statistics on either the incidence, stroke mortality or post-stroke functional outcomes along with serum uric acid levels in adults
UA is not an independent risk factor for stroke in women but higher levels do increase the risk for stroke
Summary
BackgroundStroke is the fifth most prevalent cause of death in the United States with an annual reported figure of 142,000 deaths while 795,000 individuals experience a new or recurrent stroke. Uric acid stands out as one of the most essential antioxidants in blood with a concentration almost tenfold greater than other antioxidants. Hyperuricemia is involved in the pathophysiology of several diseases such as gout, chronic kidney disease, cardiovascular diseases such as coronary heart disease, metabolic syndrome, obesity, hypertension and hyperlipidemia [4,5]. For decades it has been recognized as a major cause of gouty arthritis due to deposits of uric acid as monosodium urate (MSU) crystals in the first metatarsophalangeal joint and other various joints, tendons and tissues throughout the body. Renal under-excretion of uric acid is accountable for 90% cases of gout while the increased synthesis of uric acid contributes to only 10% cases [6]
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