Uric acid linked to later risk for irregular heart rhythm

High levels of uric acid in midlife may significantly raise the risk for a serious type of irregular heartbeat in the decades that follow, even in people without traditional risk factors, new research from Karolinska Institutet published in the Journal of the American Heart Association shows.

The study suggests that uric acid may play an important role in the development of atrial fibrillation, or AFib, an irregular heartbeat that can lead to blood clots, stroke, heart failure and other heart complications.


Mozhu Ding


Mozhu Ding, postdoc researcher at Karolinska Institutet.
Photo: Mike Lei Zhang.

“People with elevated uric acid levels may benefit from regular cardiovascular examinations to facilitate early diagnosis of new-onset AFib,” says lead study author Mozhu Ding, a postdoctoral researcher at the Institute of Environmental Medicine, Karolinska Institutet, in a news release published by the American Heart Association.

Uric acid is a chemical produced when the body breaks down purines, found in high amounts in alcohol, especially beer, and foods such as red meat, bacon, veal, organ meats, and some types of seafood, such as anchovies, sardines, scallops, herring and mussels. Uric acid is better known for its link to gout, a painful type of arthritis, and kidney stones. But studies also have linked high levels of uric acid to an increased risk for high blood pressure, diabetes and heart disease. Recent studies suggest an association between high levels of uric acid and AFib, but evidence is limited, especially among younger, healthier adults.

In the study, researchers followed 339,604 participants from Sweden for an average of 26 years. Participants, recruited from 1985 to 1996, were 30 to 60 years old and free of cardiovascular disease at the time of enrollment. Uric acid was measured at least once using a blood test. Participants were then divided into groups, ranking uric acid levels from lowest to highest.

45 percent increased risk

The study found AFib risk rose as uric acid levels rose. Overall, those with the highest uric acid levels had a 45 percent higher risk of AFib than those with the lowest levels.

Elevated uric acid levels increased AFib risk even among participants who had not developed high blood pressure, diabetes, coronary heart disease or heart failure during the follow-up period. That surprised Ding, who believes her study is the first to show this.

“This means that uric acid may not only operate through cardiometabolic mechanisms to increase the risk of AFib, but it may also have a direct influence on AFib development through other mechanisms,” she said.

More research is needed to identify those mechanisms, she said, though “inflammation may play a role.”

The study was funded by grants from the Swedish Research Council, Loo and Hans Osterman Foundation for Medical Research and Karolinska Institutet Research Foundation.


Elevated Uric Acid Is Associated With New‐Onset Atrial Fibrillation: Results From the Swedish AMORIS Cohort.” Mozhu Ding, Ngoc Nguyen Viet, Bruna Gigante, Viktor Lind, Niklas Hammar and Karin Modig, Journal of the American Heart Association, online January 12, 2023, doi: 10.1161/JAHA.122.027089

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