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New research · Internal Medicine
European journal of internal medicine · 17h
GuidelineEuropean journal of internal medicine · 2026

Expert consensus for the diagnosis and treatment of patients with hyperuricemia and high cardiovascular risk: 2025 update.

Richard Johnson, Ivan Gruev, Yoto Yotov … Mieczyslaw Litwin
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Internal MedicineGuideline
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Expert consensus for the diagnosis and treatment of patients with hyperuricemia and high cardiovascular risk: 2025 update.

Richard Johnson et al. · European journal of internal medicine · 2026
Background

Hyperuricemia has traditionally been viewed primarily as a cause of gout; however, accumulating evidence indicates that elevated serum uric acid (sUA) is also associated with increased cardiovascular and renal risk.

Methods

The recommendations are based on a critical narrative review of the literature published, including large cohort studies, meta-analyses, randomized controlled trials, and contemporary European guidelines (ESC, ESH, KDIGO, EULAR).

More results

Elevated sUA is independently associated with cardiovascular mortality, heart failure, stroke, and faster progression of chronic kidney disease.

More results

Based on current evidence, this consensus proposes a risk-based, individualized approach to hyperuricemia management and presents a pragmatic six-rung therapeutic ladder integrating lifestyle measures, optimization of comorbidities, and pharmacological urate-lowering therapy when clinically indicated.

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