The Connection Between Your Pee and Heart Health Is Anything but Basic

Even if you aren’t familiar with uric acid, you’ve likely heard of gout: a painful form of arthritis that impacts around 9.2 million people in the United States. “Most everyone has heard of gout, a painful condition affecting around 4 percent of Americans caused by the accumulation of uric acid crystals in the joints,” says David Perlmutter, MD, neurologist, and author of Drop Acid. “And truly, this is pretty much the only context in which uric acid levels have traditionally been discussed.”

People with gout might be aware of their uric acid levels, but Dr. Perlmutter says we can all benefit from paying closer attention. Below, he explains why uric acid matters, what causes uric acid levels to rise, and how increased knowledge can benefit overall heart health.

What is uric acid

Uric acid is a waste product in your blood that’s produced when your body breaks down chemical compounds called purines. Typically, uric acid is sent to your kidneys and expelled in your urine, the Cleveland Clinic explains. However, when your body is unable to process purines, the compound crystallizes and settles into the joints, which causes a condition called hyperuricemia—a common precursor to ailments like gout and kidney stones.

Risk factors like age, kidney function, diabetes, and gender, may make it harder for your body to break down purines, which raises your uric acid levels. Additionally, high-purine food like red meat, alcohol, high fructose corn syrup, and seafood can contribute to higher uric acid levels in the body, the Cleveland Clinic explains.

What’s the connection between uric acid and heart health

Gout is diagnosed in people with uric acid levels of 7 milligrams per deciliter (mg/dl), but Dr. Perlmutter points out that those with levels at or above 5.5 mg/dl have higher risks for metabolic and cardiovascular disease. A recent study published in BMC Cardiovascular Disorders, an open-access peer-reviewed medical journal, assessed 32 studies which consisted of a total sample size of 1,134,073 participants. The results laid out a distinct association between uric acid and the risk of CVD mortality, with risks proving higher for women compared to men.

In a 2020 study published in Science Reports, 500,511 Japanese subjects (40–74 years) were assessed at annual checkups over seven years. Uric acid levels of greater than 7 mg/dL in men and less than 5 mg/dL in women were associated with the aforementioned cardiovascular disease risks and cardiovascular disease mortality risks as well.

The reason that uric acid poses a risk to the cardiovascular system is that the substance inhibits the function of nitric oxide, which is a chemical that allows blood vessels to open up, Dr. Perlmutter says. When blood vessels are inhibited from opening, it increases the risk for cardiovascular disease in the long term, he says.

So what should you do with this information

Dr. Perlmutter says that the most important takeaway is that knowing your uric acid levels can help you make informed decisions about your health. Having your blood tested for uric acid levels can provide insight into your risk for developing diseases or potentially point to solutions if you’re currently struggling with uric acid-related conditions like diabetes, gout, high blood pressure, or more, he says.

However, if getting blood testing isn’t an accessible option, Dr. Perlmutter says examining your purine consumption is an excellent place to start. High fructose corn syrup, in his opinion, contributes to higher uric acid levels. In Drop Acid, he explains that fructose consumption increased an astounding 1000% between 1970 and 1990 in the U.S., and uric acid levels rose in lockstep with our fructose consumption.

Additionally, adopting a low-purine diet, drinking plenty of water, examining alcohol intake, and choosing complex carbohydrates like whole grains, vegetables, and beans are all excellent ways to support kidney function and lower uric acid levels.

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