With the improvement of living standard, people’s lifestyle and diet structure have changed, hyperuricemia (HUA) has gradually become a common disease and a prevalent disease, becoming the second endocrine metabolic disease after diabetes in China. It has become the second most common endocrine metabolic disease in China after diabetes mellitus. Who is the “fourth high” after the “three highs”? Blood uric acid level is influenced by age, gender, race, genetics, diet, drugs, environment and other factors. Epidemiological studies in the past 10 years have shown that the prevalence of HUA varies greatly from 5.46% to 19.30% in different regions of China, with 9.2% to 26.2% in men and 0.7% to 10.5% in women. Hyperuricemia is known as the “fourth high” after the “three highs” of hypertension, hyperglycemia and hyperlipidemia. Many people find high uric acid levels after medical checkups, but they don’t take it seriously because they don’t have any symptoms. The first impression people have is that hyperuricemia causes gout, so they can tolerate it or take some painkillers and it will pass. We describe the acute attack of gout like this: “In ancient times, the emperor’s family, the modern rich and noble disease, after the lights and wine, late at night when people are quiet, its fast and fast as the wind, its pain is as sharp as a cut”, which is very graphic. In fact, in addition to gout, hyperuricemia is also related to the development of kidney, endocrine metabolism, cardiovascular and cerebrovascular diseases. How dangerous is hyperuricemia? Some scholars first proposed in 1985 that hyperuricemia is associated with coronary heart disease, and studies have found that many people with high uric acid eventually develop coronary heart disease, with myocardial infarction being the main cause. A large number of studies have also found that hyperuricemia is an independent risk factor for essential hypertension, chronic kidney disease, and an independent prognostic indicator for patients with chronic heart failure, and can predict survival in patients with chronic heart failure. Hyperuricemia can also cause cerebral infarction, alcoholic and non-alcoholic fatty liver, cerebrovascular injury and other diseases. Previously, HUA was defined as non-same-day fasting blood uric acid levels >420 μmol/L in men and >360 μmol/L in women on a normal purine diet, and because the saturated concentration of urate in the blood is 420 μmol/L (regardless of gender), exceeding this value can cause urate crystals to precipitate and deposit in joint cavities and other tissues. Therefore, the latest expert consensus defines a blood uric acid level >420 μmol/L (7mg/dl) as HUA. HUA should first be treated non-pharmacologically 1. A low purine diet should be the main focus, and the intake of high purine foods such as animal offal, seafood and meat should be strictly limited. Purine-rich vegetables (lettuce, spinach, mushrooms, cauliflower, etc.), beans and soy products are not significantly correlated with HUA and gout attack. Patients are encouraged to consume more fresh vegetables and moderate consumption of beans and soy products (those with renal insufficiency must consume them under the guidance of specialist). 2.Patients with normal heart and kidney function should maintain proper body water, drink more water and maintain daily urine volume of 2,000-3,000ml, drink milk and dairy products (especially skim milk and low-calorie yogurt), avoid drinking cola, orange juice, apple juice and other fructose-containing drinks or sugary soft drinks. The relationship between coffee and HUA and gout is inconclusive. Fruits are rich in potassium and vitamin C, which can reduce the risk of gout attack, and HUA patients can consume fruits with less fructose, such as cherries, strawberries, pineapples, watermelon, peaches, etc. HUA patients should limit alcohol intake and prohibit drinking yellow wine, beer and white wine. Whether red wine increases blood uric acid level is controversial. 5. Reducing body weight can effectively lower blood uric acid levels. It is recommended that HUA patients should keep their body weight in the normal range (BMI 18.5 to 23.9 kg/m2). 6. Encourage HUA patients to adhere to moderate exercise. At least 150 min per week (30 min/d×5d/week) of aerobic exercise with a heart rate within the range of (220-age) × (50%-70%)] of moderate intensity exercise is recommended. Strenuous exercise or sudden cold induced gout attacks should be avoided during exercise. 7. Smoking or passive smoking increases the risk of HUA and gout, and smoking cessation and passive smoking should be avoided.