With China’s economic development and the improvement of people’s living standards as well as changes in lifestyle, the prevalence of hyperuricemia and gout is increasing year by year. In coastal and economically developed areas, the prevalence of hyperuricemia is above 20%, which has reached or approached the level of developed countries in Europe and America. Hyperuricemia shows a high incidence, younger, male than female, coastal than inland epidemic trend, has become a common and has a wide range of harmful metabolic diseases. In the clinic often encountered due to elevated uric acid and even gout patients, they have little knowledge of uric acid, in fact, hyperuricemia has become high blood pressure, high blood lipids, high blood sugar after the “fourth high”, thus becoming the “invisible killer”, so the We must pay attention to hyperuricemia and take it seriously. I will do a comprehensive explanation of high uric acid and gout in several installments. First, what is uric acid? Body tissues are composed of cells, the body’s activities in the microscopic is cellular activity, in this process will produce many metabolites, uric acid is one of them. Uric acid is one of the many metabolites produced in the process. The upper level substances that are converted into uric acid are called purines, which come from cellular metabolism and various foods such as seafood and animal offal. Every day in the human body, food digestion and absorption and produce purines and then produce uric acid, uric acid and then through the kidneys dissolved in the urine and finally excreted into the body. This is the whole process of uric acid production and metabolism. Uric acid in the body is not easy to dissolve substances. Therefore, if the amount of uric acid in the body continues to increase, exceeding the ability to be excreted from the kidneys, the uric acid will show crystallization. This crystallization of uric acid will be deposited in various tissues and organs of the body, causing harm to the function of organs and tissues. Second, what can cause uric acid elevation? The reason for the increase of uric acid is divided into two aspects, the first is to produce too much, mainly due to exogenous high purine food intake and due to some diseases lead to their own purine production increase; the second is to reduce the excretion, the body will produce a certain amount of uric acid every day, but also by the kidneys through the urinary excretion of part of the uric acid. However, if the kidney function declines, it will lead to poor uric acid excretion, the body’s uric acid production and excretion of the balance is destroyed, there will be a continuous increase in uric acid in the body, and finally appear hyperuricemia. In addition, the body’s acidic environment is not conducive to the excretion of uric acid, therefore, when the body’s long-term diet of acidic foods such as a variety of meats, will also cause elevated uric acid. Third, what is the danger of elevated uric acid? As we all know, hyperuricemia is the most direct cause of gout, urate crystals in the body tissue deposition and damage caused by gout. However, only 5-12% of patients with hyperuricemia develop gout, and most patients with hyperuricemia do not experience joint swelling or pain. Hyperuricemia without gout is called asymptomatic hyperuricemia, so does this asymptomatic hyperuricemia need treatment? A large number of studies have confirmed that hyperuricemia is not only closely related to gout, but also has obvious correlation with diabetes, hyperlipidemia, chronic kidney disease, cardiovascular disease and stroke. 1, diabetes: with the rise of blood uric acid level, the risk of type 2 diabetes mellitus also increases, on the contrary, type 2 diabetes mellitus patients with hyperuricemia incidence also increased significantly. 2, cardiovascular disease: there is a causal relationship between hyperuricemia and the development of hypertension, and blood uric acid is an important risk factor for predicting the occurrence of cardiovascular events. It can significantly increase the risk of death from cardiovascular disease. Reducing blood uric acid can significantly improve the blood supply and function of the heart. 3, kidney disease: elevated blood uric acid levels can lead to acute uric acid nephropathy, chronic uric acid nephropathy and kidney stones, increasing the risk of renal failure. And renal insufficiency is an important risk factor for gout. The prevalence of chronic kidney disease and diabetic nephropathy increases significantly with higher blood uric acid, while survival decreases significantly, and blood uric acid is also a strong predictor of the development of acute and chronic renal failure and poor prognosis. Renal failure due to uric acid nephropathy has become one of the most common causes of death in gouty arthritis. 4, stroke: uric acid crystals deposited in the blood vessel wall, promote inflammatory reaction, promote lipid peroxidation, so that the generation of oxygen free radicals increase, promote the development of atherosclerosis, but also promote the occurrence and development of stroke. Fourth, does hyperuricemia need treatment? Many patients with hyperuricemia do not have any clinical symptoms, neither feel uncomfortable nor pay attention, due to the lack of awareness of hyperuricemia, not to mention the lack of long-term effective treatment. We should realize that hyperuricemia causing gout attacks and joint damage is only one of its obvious clinical manifestations; in addition, hyperuricemia will also lead to chronic damage to the vascular endothelium and kidneys, aggravate insulin resistance, and increase the risk of diabetes mellitus, as well as hypertension, coronary heart disease, stroke and other diseases. We should treat hyperuric acid as a comprehensive cardiovascular and cerebrovascular risk factor and take a comprehensive view of the dangers of hyperuricemia. So when should we start uric acid-lowering treatment? There are three indicators to determine whether to treat: first, the uric acid value is high or low; second, whether there has been an attack of gout; third, whether there are cardiovascular risk factors, such as hypertension, diabetes mellitus, hyperlipidemia and so on, are all risk factors; to determine whether there are cardiovascular risk factors need to be assessed by a doctor face to face. If there are no symptoms, no cardiovascular risk factors, and the uric acid value is 420-540 μmol/L, no medication is needed. If there are cardiovascular risk factors such as hypertension and diabetes, and the blood uric acid is >420 μmol/L, then medication should be considered to lower uric acid. If there are no cardiovascular risk factors and blood uric acid >540μmol/L, you should also start taking medication to lower uric acid. Finally, I hope you know that you should not only focus on hypertension, hyperlipidemia and hyperglycemia, but also understand hyperuricemia!