Thank you for this literature review. We were always taught in medical school that gout, associated with high uric acid levels was a “rich man’s disease.” I remember lecture slides (long before PowerPoint) of an obese elderly, man shoveling rich cuts of beef into his mouth while slurping wine. I think there is a real association of high uric acid levels with cardiovascular disease and various metabolic syndromes. Whether it is an independent contributor to heart disease and if so, how, remains elusive.