From Purines to Plaques: Serum Uric Acid as a Cardiometabolic Marker and Its Correlation With Dyslipidemia in Essential Hypertension

Background Metabolic disturbances, particularly lipid abnormalities and increased uric acid levels, are commonly observed in essential hypertension and may play a role in endothelial injury and heightened cardiovascular risk. Assessing the relationship between serum uric acid and lipid abnormalities may enhance risk profiling in hypertensive patients. Methodology A hospital-based, cross-sectional study was conducted in the Department of General Medicine, Sree Balaji Medical College and Hospital, Chennai, from August 2023 to February 2025. In total, 60 adults aged 35-65 years with essential hypertension (blood pressure >140/90 mmHg) were included. Patients with diabetes, obesity, gout, systemic illnesses, alcohol or tobacco use, or prior lipid-lowering therapy were excluded. After obtaining informed consent, clinical details and anthropometric measures were collected. Fasting samples were analyzed for serum uric acid and lipid profile parameters. Associations between uric acid and lipid fractions were assessed. Results Of the 60 hypertensive individuals, 68.3% had hyperuricemia (≥7.0 mg/dL). This group exhibited significantly higher mean triglycerides (195.8 vs. 180.3 mg/dL), low-density lipoprotein (144.4 vs. 132.9 mg/dL), and very-low-density lipoprotein (40.9 vs. 37.1 mg/dL), along with lower high-density lipoprotein (45.2 vs. 47.3 mg/dL) compared to those with lower uric acid levels. Dyslipidemia was more prevalent among hyperuricemic patients (92.6% vs. 78.9%). Serum uric acid also showed a positive correlation with systolic blood pressure and body mass index. Conclusions Elevated serum uric acid is significantly associated with adverse lipid profiles in essential hypertension. Hyperuricemia may act as a metabolic marker, underscoring the importance of early detection and combined management of uric acid and lipid abnormalities to reduce cardiovascular risk.