Low acid uric in primary prophylaxis: worthy?

•Cardiovascular disease (CVD) is the leading cause of mortality worldwide.•Strong evidence about potential efficacy and safety of XO inhibition•Maybe serum uric acid levels correlate with many risk factors.•Uric acid lowering therapy doesn't convey beneficial cardiovascular effects.

Cardiovascular disease (CVD) is the leading cause of mortality worldwide. Many traditional risk factors have been identified. Early detection of high-risk subjects is very important to make the prevention of CVD more effective. There is a considerable documentation that serum uric acid (SUA) levels correlate with many recognized cardiovascular risk factors, and in recent years it has been collected strong evidence that suggests the potential efficacy and safety of XO inhibition in cardiovascular disease. Unfortunately, recent trials that evaluated oxypurinol and allopurinol failed to show clinical benefit in patients with HF and reduced ejection fraction.