You probably know your cholesterol level, and I am sure you know your glucose level, but what is your uric acid level (UA)?
Most of us think of gout, “the kings’ disease” when asked about UA levels, however, with an estimated 68% of American adults overweight or obese, it is an epidemic. Unfortunately, an elevated uric acid level can also be linked to cardiovascular disease (CV) and diabetes.
UA is a breakdown product from purines – you know, Thanksgiving turkey – but also liver, dried beans and peas, and beer. Your kidneys are responsible for removing UA. If the kidneys don’t remove enough of the UA then you have hyperuricemia which can lead to gout and CV disease.
Uric Acid Level Study Connects Mortality Rate To Gout
In one study colchicine, a medication that lowers UA, lowered the risk of CV in gout patients by 43% and all-cause mortality by 73%. Another study of patients with angiogram confirmed coronary artery disease found that patients with high levels of UA were five times more likely to die than those with low levels of UA. Each 1 mg/dl increase of UA was associated with a 26% increase in mortality.
We commonly see elevated UA in patients with hypertension possibly due to a defect in the ability of the kidneys to eliminate UA. Studies show a 3-5 increase risk of strokes or cerebral vascular disease (CVD) in patients with hypertension and elevated UA levels. The Worksite Treatment Program showed a 1 mg/dl increase in UA was associated with a 32% increase in CVD.
Even diabetes is associated with elevated UA levels. The Framingham Study, which included 4,883 participants, showed a 20% increase in the risk of developing type 2 diabetes. And, just like
hypertension, the risk of stroke in diabetics increases as the uric acid level increases.
Keep your uric acid level down. Besides weight loss and increased activity, there are certain foods to reduce or eliminate in your diet.
Food Can Affect Your Uric Acid Level
Foods very high in purines:
- Organ meats, such as liver, kidneys, sweetbreads, and brains
- Meats, including bacon, beef, pork, and lamb
- Anchovies, sardines, herring, mackerel, and scallops
- Beer, wine, and liquor
- Fruit juices and soda
Vitamin C rich foods and cherries show evidence of reducing gout attacks:
Finally, medications that help:
- Allopurinol. This once daily medication blocks the formation of UA by inhibiting an enzyme, xanthine oxidase, involved in its production. It will lower you level by 1-3 mg/dl (30%). It is also
- an antioxidant.
- Probenecid. This older medication helps promote the excretion of UA and will also lower levels by 30% to 35%.
- Losartan. If you have elevated blood pressure this is a great medication to use. It reduces the reabsorption of UA and can reduce your levels by 20% to 25%. Unfortunately, the other blood pressure medications in this class (ARBs) do not have this property and may actually increase UA.
- AVOID diuretics. They will increase UA levels.
So, once more the true answer to living healthy is a healthy lifestyle. Plenty of exercise. Weight reduction, and a Mediterranean style diet.
Live Healthy America,
James Krider, MD