the Link Between High Uric Acid and Heart Health

Cardiac issues and elevated uric acid levels?

Cardiac issues: I experience shortness of breath while jogging, which prevents me from continuing.
This phenomenon occurs about 10 minutes into jogging (I haven't recorded it carefully).
Which department should I visit for an examination, or what should I pay attention to before making an appointment? My cardiac health check showed abnormalities, including lactate dehydrogenase (LDH) at 134 and elevated uric acid levels: my most recent test showed uric acid at 8.9 (male).
I drink a cup of soy milk every morning.
After visiting the metabolic department, I was told there are no issues related to gout or thyroid problems.
Could elevated uric acid levels have implications for kidney and heart health? Thank you.
I am still young, and I know I shouldn't compare myself to older individuals, as it can easily lead to underestimating mild symptoms, which may cause delays.
Previous health check data showed abnormalities in metabolic items, including homocysteine at 12.32 and high-sensitivity C-reactive protein at 3.08, both of which were elevated.

wei, 30~39 year old female. Ask Date: 2018/02/28

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your question.
Indeed, there is a trend of metabolic diseases occurring at younger ages, and it's great that you are being vigilant.
Regarding your concerns, my recommendations are as follows:
1.
If you experience shortness of breath during jogging, it would be advisable to consult a cardiologist, especially since your high-sensitivity C-reactive protein is elevated, indicating a higher risk for cardiovascular diseases.
Therefore, I suggest you see a cardiologist first.
2.
Elevated uric acid levels do not necessarily require immediate intervention.
Recent studies indicate that consuming soy milk does not affect uric acid levels, so you can continue to enjoy it without worry.
However, since your uric acid is at a concerning level, it is increasingly recognized that high uric acid is associated with renal dysfunction and heart disease.
I recommend that you have your uric acid levels checked regularly, such as every six months.
3.
If your elevated uric acid is accompanied by joint pain, it may be necessary to start medication for control.
Please consult a rheumatologist for further evaluation.
The Department of Allergy, Immunology, and Rheumatology at Changhua Hospital, Ministry of Health and Welfare, is here to support you.

Reply Date: 2018/02/28

More Info

Understanding the link between high uric acid levels and heart health is crucial, especially for individuals who experience symptoms like shortness of breath during physical activities such as jogging. Your situation involves several interconnected health concerns, including elevated uric acid levels, abnormal lactate dehydrogenase (LDH) levels, and elevated homocysteine and high-sensitivity C-reactive protein (hs-CRP) levels. Each of these factors can provide insights into your overall cardiovascular health.

Uric Acid and Heart Health
High uric acid levels, known as hyperuricemia, can be associated with various health issues, including cardiovascular diseases. Uric acid is a waste product formed from the breakdown of purines, substances found in many foods. When uric acid levels become elevated, it can lead to conditions like gout, but it is also linked to hypertension, heart disease, and kidney problems. The mechanism behind this association is thought to involve oxidative stress and inflammation, which can damage blood vessels and promote atherosclerosis (the buildup of plaque in arteries).

Symptoms During Exercise
The shortness of breath you experience while jogging could be indicative of several underlying issues. It may be related to cardiovascular problems, respiratory conditions, or even musculoskeletal issues. Given that this symptom occurs after exertion, it is essential to consider a cardiovascular evaluation. You should consult a cardiologist who can perform tests such as an electrocardiogram (ECG), echocardiogram, or stress testing to assess your heart's function during physical activity.

Elevated LDH Levels
Lactate dehydrogenase (LDH) is an enzyme found in many tissues throughout the body, and elevated levels can indicate tissue damage or disease. While LDH is not specific to any one condition, elevated levels can be associated with heart disease, liver disease, and certain cancers. In your case, it may be worthwhile to investigate the cause of the elevated LDH levels further, particularly in the context of your other symptoms and lab results.

Homocysteine and hs-CRP
High levels of homocysteine are another risk factor for cardiovascular diseases. Elevated homocysteine can lead to endothelial dysfunction and promote atherosclerosis. It is often related to deficiencies in vitamins B6, B12, and folate, which are essential for its metabolism.
High-sensitivity C-reactive protein (hs-CRP) is a marker of inflammation in the body. Elevated hs-CRP levels indicate an inflammatory response, which can be associated with an increased risk of cardiovascular events. This inflammation can stem from various sources, including chronic diseases, infections, or lifestyle factors such as obesity and smoking.

Recommendations
1. Consult a Cardiologist: Given your symptoms and lab results, it is advisable to see a cardiologist for a thorough evaluation. They may recommend further testing to assess your heart's health and rule out any significant cardiovascular issues.

2. Dietary Adjustments: Since you mentioned drinking soy milk, which is high in purines, consider moderating your intake of high-purine foods (e.g., red meat, organ meats, certain seafood) to help manage uric acid levels. A balanced diet rich in fruits, vegetables, whole grains, and low-fat dairy can be beneficial.

3. Lifestyle Changes: Regular exercise, maintaining a healthy weight, and staying hydrated can help manage uric acid levels and improve overall cardiovascular health. However, be cautious with exercise intensity until you have a clearer understanding of your heart health.

4. Monitor Symptoms: Keep track of your symptoms, including when they occur and their severity. This information will be valuable for your healthcare provider.

5. Follow-Up on Lab Results: Discuss your elevated LDH, homocysteine, and hs-CRP levels with your healthcare provider to determine if further investigation or treatment is necessary.

In summary, while high uric acid levels can have implications for heart health, your symptoms and lab results warrant a comprehensive evaluation by a healthcare professional. Early intervention and lifestyle modifications can significantly impact your long-term health outcomes.

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