The role of uric acid in stroke: the issue remains unresolved.

Abstract Although in the past decade a large number of studies have been performed to identify the relationship between uric acid and stroke, the issue remains unresolved and it is not clear whether the correlation between uric acid and stroke is circumstantial or causal. Some studies have found uric acid predictive for the development of cardiovascular disease, whereas others have failed to identify uric acid as a significant and independent risk factor after controlling for other atherosclerotic risk factors. Furthermore, uric acid, a powerful endogenous antioxidant, is increased in oxidative stress situations such as stroke. Still, it remains controversial whether elevated serum uric acid is neuroprotective or injurious at the onset of acute stroke. Large trials are required to provide definite answers in clinical practice and to reevaluate the goals of hypouricemic treatment in subjects with increased cardiovascular risk or during an acute cardiovascular event like stroke. This review tries to keep pace with the data concerning the association between uric acid and stroke.