Hyperuricemia is diagnosed when the level of uric acid in the blood exceeds 420 μmol/L (7.0 mg/dl) for men and 360 μmol/L (6.0 mg/dl) for women. In the last thirty years, China’s hyperuricemia is increasing year by year, men are higher than women, economically developed cities and coastal areas are higher than other areas, the prevalence of hyperuricemia in high prevalence areas is as high as 23.5%, and the prevalence of people with the disease has exceeded that of diabetes mellitus and is close to that of high blood pressure. This is related to factors such as people in the region consuming too much seafood, animal offal and meat foods with high purine content and drinking a lot of beer. In addition to the dangers to the joints and kidneys, simple hyperuricemia has the following dangers: When to initiate uric acid-lowering therapy? What is the goal of uric acid-lowering therapy? Asymptomatic hyperuricemia is not harmless and will benefit from uric acid-lowering therapy. But when should uric acid-lowering therapy be initiated? According to expert consensus, initiation of uric acid-lowering therapy should be initiated in the following cases: 1. blood uric acid >540 μmol/L, then unconditional uric acid-lowering therapy should be initiated; 2. blood uric acid >480 μmol/L if there has been a previous gouty attack or if there has been no gouty attack but there is the presence of any of the following: uric acidic renal stones, glomerular filtration rate of ≤60 ml/min, hypertension, diabetes, diabetes mellitus Hyperlipidemia, obesity, coronary heart disease, stroke, cardiac insufficiency, etc., should also start uric acid-lowering treatment; 3. Have two or more gouty attacks in the past, or have one gouty attack, but combined with any of the following: age <40 years old, gouty stone, uric acid renal stone, glomerular filtration rate ≤60ml/min, hypertension, diabetes mellitus, hyperlipidemia, obesity, coronary heart disease, stroke, cardiac insufficiency, etc., regardless of the level of blood uric acid. etc., should also start uric acid-lowering therapy regardless of the level of blood uric acid. Blood uric acid control goals of uric acid-lowering therapy: (1) Allopurinol: initial dose of 50~100mg/day, maximum dose of 600mg/day for adults. Patients with renal insufficiency should reduce the dose, the dose is 50~100mg/d when the glomerular filtration rate is ≤60ml/min, and it should be disabled when the glomerular filtration rate is ≤30ml/min; allopurinol can cause skin allergy and liver and kidney function damage, and exfoliative dermatitis can occur in severe cases. Exfoliative dermatitis is a lethal hypersensitivity reaction, often occurring in HLA-B*5801 gene positive people, while the application of thiazide diuretics and renal insufficiency is also prone to occur. HLA-B*5801 gene in the Han Chinese, Koreans, Thais, the rate of positivity is significantly higher than that of Caucasian people, it is recommended to take allopurinol treatment before the screening for the gene, the positive is prohibited. (2) Febuxostat: Initial dose 20~40mg/day, maximum dose 80mg/day. It is safe for the kidneys and does not require dose reduction for mild to moderate renal insufficiency, and is used with caution in severe renal insufficiency (glomerular filtration rate ≤ 30 ml/min). Adverse reactions include hepatic impairment, nausea, skin rash. 2, increase uric acid excretion of drugs: benzbromarone: adult starting dose of 25~50mg/day, maximum dose of 100mg/day, taken after breakfast. Safe for the kidneys, glomerular filtration rate of 20~60 ml/min, recommended 50mg/day, glomerular filtration rate <20 ml/min, or uric acid nephrolithiasis patients are prohibited. Adverse reactions include gastrointestinal upset, diarrhea, rash and hepatic impairment. Colchicine, hormones, painkillers are therapeutic drugs for acute gouty arthritis and have no uric acid-lowering effect; baking soda tablets can be used in conjunction with benzbromarone to lower uric acid, and have no uric acid-lowering effect when used alone. From the history of treatment of hypertension to see on the uric acid-lowering treatment can be inspired? Franklin D. Roosevelt was the president of the United States during World War II, one of the most popular presidents in American history, and the only one to serve four consecutive terms as president of the U.S. On April 12, 1945, the eighth week after the end of the Yalta Conference, which determined the pattern of the post-war world, he died of a cerebral hemorrhage due to high blood pressure at the age of 63 in the presidency. Let's take a look at Roosevelt's blood pressure: in 1935 (53 years old), 136/78mmHg; in 1941 (59 years old), 188/105mmHg; in 1944 (62 years old), at the time of the Normandy landings, 226/118mmHg, and when he ran for the presidency, 200/100mmHg; in 1945 (63 years old), at the time of the Yalta Conference, 260/150mmHg. 150 mmHg. But he never received treatment. At that time, the medical profession had been treating hypertension as a compensatory mechanism of the body, believing that atherosclerosis required a higher blood pressure to allow blood to pass through narrowed vessels, and therefore should not be interfered with. a book on cardiology, published in 1949, defined a blood pressure of no more than 210/100 mmHg as benign hypertension. So, the high blood pressure of a country that was the head of the most technologically advanced and powerful nation was never controlled with any medication. It wasn't until three years after Roosevelt's death that his successor, President Truman, signed the National Heart Act, established the National Heart Institute, and earmarked funds to launch the Framningham Study, an epidemiologic study of heart disease. The study confirmed that "high blood pressure and high cholesterol are risk factors for heart disease" and that "high blood pressure is a risk factor for stroke". "Hypertension" is no longer considered to be a normal variation of physiology, but a disease that must be effectively and scientifically controlled and managed. There is now a consensus that hypertension should be treated regardless of whether it is symptomatic or not in order to prevent complications. And hypertension should be treated not only to treat it, but also to meet the standard. So perhaps the same should be true for high uric acid? All of this is waiting to be confirmed by more research!