Asymptomatic hyperuricemia is common and occurs in up to 10% of adults and often is a coincidental laboratory finding. When serum uric acid levels are significantly elevated, however, you should look for a possible correctable cause such as intermittent alcohol abuse, medications (especially diuretic use), obesity, or an underlying metabolic condition or malignancy. Remember, alcohol may both increase the production of uric acid and impair its excretion. Drug therapy isn’t recommended for asymptomatic hyperuricemia unless the serum uric acid levels are markedly elevated (≥ 600 µmol/L in women and ≥ 750 µmol/L in men). Lifestyle modification is the mainstay. Patients should be advised to lose weight if obese and to reduce their intake of alcohol. Although diet plays a minor role, dietary counselling (low purine diets) may be adjunctive to medical management. In patients with high blood pressure and hyperuricemia, losartan is the preferred antihypertensive for its uricosuric effect, in addition to its effect on BP.

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