Talking about the “three highs” enemies – high blood sugar, high blood pressure and high blood fat – which bring great threats to people’s health in modern society, we will not be unfamiliar with them. Nowadays, the fourth high after the “three highs” – high uric acid has also surfaced and is coming on strong. “Know your enemy and know yourself, and you will not be in danger in a hundred battles”, in order to defeat the enemy, you must first understand the enemy. Regarding high uric acid and gout, there are quite a few common misconceptions in the society, it is necessary to sort out and learn with you. Myth one, high uric acid is equal to gout Gout originates from high uric acid, but it does not mean that there is high uric acid will definitely have gout, only when the blood uric acid crystals deposited in the synovial membrane of the joints, and cause synovial inflammation will lead to the occurrence of gout, in fact, only about 10% of the patients with high uric acid will occur gout. In turn, the same, due to the complexity of the causative factors of gout, many patients in the gout attack, blood uric acid levels may still be within the normal range, this time do not be superstitious in the test results and delayed timely treatment of gout. Myth two, high uric acid will only cause gout Uric acid is the end product of purine metabolism in the human body, high uric acid on the human body has a harmful effect on a number of tissues and organs. Excessive uric acid deposits in the bones, joints, will cause gout. Deposits in the kidneys can cause kidney disease, inducing kidney failure. High uric acid will also greatly increase the risk of a variety of metabolic diseases (such as obesity, diabetes, hyperlipidemia, etc.) and cardiovascular disease. Myth 3: Everything is fine if uric acid is normal According to international standards, the normal range of uric acid is <420 μmol/L for men and <360 μmol/L for women, but for patients with gout, it is not enough to control uric acid in such a "normal" range, and the latest guideline suggests that blood uric acid in patients with gout should be lowered to below 360 μmol/L, and those who are combined with renal uric acid stones should be lowered to below 300 μmol/L, so as to reduce the number of patients with gout and to reduce the risk of kidney failure. mol/L or less, so as to reduce the frequency of gout flare-ups, minimize the size of gout stones that have formed, and further avoid the deposition of crystals. Myth four, high uric acid, no gout is not treated The controversy over this issue has a long history, but now the academic community has basically unified opinion: no matter how "healthy" a person, as long as the uric acid exceeds a certain value, it should be reduced uric acid treatment. If the person also has diabetes, chronic kidney disease or cardiovascular disease risk factors, then as long as the uric acid exceeds the above normal range, even if there is no gout attack, you need to start treatment. Myth 5, acute attack can not lower uric acid Long-term views are that if the use of uric acid-lowering drugs in the acute phase of gout, may lead to gout stone surface dissolution in the joints, the formation of insoluble crystals deposited in the tissues to aggravate the inflammatory response. Therefore, "no uric acid-lowering drugs should be used during the acute phase of gout" has almost become the golden rule in gout treatment. However, in 2012, the U.S. Guidelines for the Management of Gout for the first time suggested that uric acid-lowering therapy is not contraindicated in the acute phase under the protection of effective anti-inflammatory drugs. This was followed by the 2013 Chinese Expert Consensus on the Treatment of Hyperuricemia and Gout, which also endorsed this view, suggesting that instead of waiting two weeks for the acute symptoms of gout to resolve, uric acid-lowering therapy can be started immediately. Clinicians generally still tend to take a conservative attitude towards this "counterintuitive" avant-garde concept. After all, the old idea has been around for a long time and is deeply rooted in people's hearts; the new idea also needs more evidence-based evidence, and its greater clinical significance lies in the fact that patients who experience acute attacks of gout while taking uric acid-lowering medications do not need to stop uric acid-lowering therapy. Myth six, diet alone can lower uric acid human blood uric acid, 80% from their own purine metabolism, only 20% from food intake. Therefore, by simple dietary control to reduce blood uric acid levels is very limited (most can only drop 10% to 20% or 70 to 90μmol / L). Therefore, medications must be chosen according to the condition. Many patients refuse to take medication for fear of side effects, which is a typical case of "giving up eating for fear of choking". As long as the scientific and standardized use of drugs, the risk of rare complications of drugs is not higher than the possibility of going out and getting into a car accident, who would stay at home all day because of the fear of car accidents? Myth seven, lower uric acid by drugs alone is enough After the application of uric acid-lowering drugs, some patients think that from now on there is no worry, you can feast on the diet, "the big deal is to take more tablets," such an idea is not only wrong and dangerous. For chronic metabolic diseases like gout, a "low purine" diet is the prerequisite and foundation for treatment. Without reducing purine intake at the source, medication alone cannot control the disease. As a result of dietary excesses, uric acid rises significantly and the dose of medication has to be increased, which greatly increases the risk of adverse drug reactions.