Hyperuricemia may be a risk factor for coronary heart disease, and therefore the relationship between gout and cardiovascular disease has been of interest. A paper published online in 2010 in the Annals of the Rheumatic Diseases (2010; DOI:10.1136/ard.2009.1227701) pointed out for the first time that gout is an independent risk factor for coronary heart disease in female patients. is an independent risk factor for coronary heart disease in female patients. This was a prospective, population-based cohort study of the association between gout and acute myocardial infarction in women of advanced age, conducted in Canada. The British Columbia Health Database is used to identify patients with high uric acid, a database covering the entire province of 4.3 million people and providing long-term health consultation, hospitalization and medication. The BC Musculoskeletal Centre covered a population of 3.5 million people with any musculoskeletal problem between 1991 and 2004, and the study compared 9,642 patients with gout (3,890 women) with a control population of 48,210, with an average age of 75 years for women and 73 years for men. Enrollees in this study could not have underlying heart disease. Gout was diagnosed according to the International Classification of Diseases and the more evidence-based criteria for patients over 65 years of age. Acute myocardial infarction was diagnosed according to the International Classification of Diseases and corrected criteria. The study included the period from inception to the onset of acute myocardial infarction, death, or the end of the study. The results found that 3,268 AMIs occurred after an average of 7 years of follow-up, including 996 cases in women. Women with gout had a 40% increased risk of AMI compared to women without gout, with an overall relative risk of 1.39 (95% CI: 1.20–1.61) for women with gout and a relative risk of 1.41 (95% CI: 1.19–1.67) for fatal AMI. The unexpected finding was that the relative risk was significantly higher for women than for men, with a p-value of 1.11 for both men and 0.003 and 0.005 for women, respectively, and this high risk persisted after adjusting for differences in age, comorbidities, and medications. The study’s principal investigator, Dr. Mary (Boston Medical School), and her colleagues emphasized that women with gout are at greater risk than men, and explained in heartwire, one of the major international online heart networks, that this study has been confirmed in previous studies of male patients. The researchers noted that after adjusting for other risk factors for developing acute myocardial infarction in women compared to men, women with gout still had a higher risk of acute myocardial infarction, as seen in non-fatal myocardial infarction (but not fatal myocardial infarction). Gout is caused by elevated uric acid, and the elevated uric acid can form crystals in the joints and surrounding tissues. Researchers believe that the relationship between gout and coronary artery disease could indicate that high uric acid may lead to a value-added and inflammatory response in vascular few and smooth muscle cells, and may also cause platelet adhesion and accumulation. Regarding the reason why the risk of acute myocardial infarction due to gout is higher in women, researchers believe that basal uric acid levels are actually high in men, but that uric acid only begins to increase in women around the time of menopause, and that this relative deterioration process in women may have a stronger physiological disruption than in men. Cardiologists may always consider gout as a risk factor for heart disease in men and should be aware of the same in female patients. The clinical manifestation of gout is a multi-organ maladjustment and dysfunction, while it is actually an inflammatory/metabolic process, just like diabetes. Therefore, it is not a miracle that uric acid causes cardiovascular disease, which is often not taken into account by clinicians. According to epidemiological surveys, 9% of older men and 6% of older women have gout, and in men, gout appears to have a higher risk of coronary artery disease, and that is because this has not been studied much in women, and the findings of this study should clearly be of interest to clinicians, and the results of this study provide a clinical basis for managing women with gout at high cardiovascular risk. Clinicians should intensify treatment of both male and female patients with gout to prevent cardiovascular risk.