Elevated blood uric acid levels (>430umol/L) are a common manifestation of combined metabolic abnormalities in patients with hypertension. About half of the patients with untreated hypertension have hyperuricemia, and a significant number of them have gout. Diuretics promote uric acid reabsorption in the proximal tubules of the kidney, resulting in elevated uric acid levels that can trigger gout attacks; aspirin competitively inhibits uric acid excretion; and patients with renal insufficiency are often associated with elevated uric acid. The presence of hyperuricemia in hypertensive pregnant women is an important symptom of pre-eclampsia. Everyone with first diagnosis of hypertension should have their uric acid checked, once a year in hypertensive patients with normal uric acid, and every 2-3 months in those with high uric acid.