Practitioner Course

Hyperuricaemia and its Relationship to Heart Disease

An update on uric acid and gout and their relationship to heart disease.

Online Course
1 lesson


12 Months OR Subscriber Pass


1 hour total


Richard Johnson

About this course

The increasing incidence of obesity and metabolic syndrome over the past few decades has coincided with a marked increase in total fructose intake. Fructose, unlike other sugars, causes serum uric acid levels to rise rapidly and uric acid reduces levels of endothelial nitric oxide, a key mediator of insulin action. Interestingly, along with its inflammatory properties, nitric oxide increases blood flow to skeletal muscle and enhances glucose uptake and animals deficient in endothelial nitric oxide develop insulin resistance and other features of metabolic syndrome.

Dr Rick Johnsons research shows that the epidemic of the metabolic syndrome is due in part to fructose-induced hyperuricaemia that reduces endothelial nitric oxide levels and induces insulin resistance. Consistent with this hypothesis is the observation that changes in mean uric acid levels correlate with the increasing prevalence of metabolic syndrome. The prevalence of metabolic syndrome increases substantially with increasing levels of serum uric acid. 

Dr Johnson and his team have observed that a serum uric acid level above 5.5 mg/dl independently predicted the development of hyperinsulinemia at both 6 and 12 months in non-diabetic patients with first-time myocardial infarction. Fructose-induced hyperuricaemia results in endothelial dysfunction and insulin resistance, and might be a novel causal mechanism behind heart disease. He postulates that uric acid contributes to heart disease due to its inflammatory potential and looks at the causal relationship between gout and high uric acid and cardiovascular disease. It turns out that urate crystals are present not just in the joints, but in the vasculature and there is a direct association with these crystals and vascular calcification.

Metabolic syndrome is a comorbidity of hyperuricaemia and needs treatment to prevent serious complications, including heart disease. 
Dr Johnson will discuss ways to lower uric acid via diet, Vitamin C and medication. Dr Johnson is a prolific scientist with research that's been funded by the NIH since the 1980s. He has published over 700 papers and lectured in over 45 countries. His work has been highly cited and his books include "Sugar. The fat switch." and "Nature Wants Us To Be Fat."

Google Scholar link to Dr Johnsons work.
What you receive:
  • Clear protocol explanations from some of the world's top practitioners
  • Clinical pearls for improved practice results
  • Access to your audio and video recordings via the App Store
  • A downloadable PDF of the presenter’s slides
  • Links to all referenced research papers and useful clinical handouts
  • Access to the community hub where you can get answers to your questions
  • A 30-day money back guarantee

From this course you will learn

  • How uric acid is linked with sugar, obesity and metabolic syndrome
  • The causal relationship between gout, high uric acid and cardiovascular disease
  • Epidemiological and genetic evidence for heart disease and the recent recognition that inflammation is important
  • How urate crystals are present not just in the joints, but in the vasculature
  • About the association of crystals with vascular calcification
  • That soluble uric acid as an inflammatory mediator and ways to lower uric acid

What's in this course

Your Presenter


Dr. Richard Johnson is a professor of medicine at the University of Colorado and is a clinician, educator, and researcher. He is board certified in internal medicine, infectious diseases, and kidney disease and is the founding editor of Comprehensive Clinical Nephrology, one of the main textbooks on kidney disease.

For more than 20 years, he has led research on the cause of obesity and diabetes, with special interest in the role of sugar (especially fructose) and uric acid. His research has been highly cited, published in top medical journals, and supported by grants from the National Institutes of Health. He is the author of The Sugar Fix and The Fat Switch.