Is the risk of cardiovascular disease higher in gout patients than in the general population? Why?

Yes, the risks are indeed significantly higher. This is not an exaggeration.

You can imagine our blood vessels as the water pipes in your home, and blood as the water flowing through them.

The root cause of gout is excessively high uric acid levels. When the concentration of uric acid in the blood becomes too high, it precipitates into crystals called "urate." You can think of these crystals as the "scale" or "impurities" that slowly form inside a water pipe.

Damaging the "Pipe" Walls: These sharp urate crystals don't just go into your joints, causing excruciating pain; they also "drift along" in your blood vessels. They can scratch and irritate the inner lining of the blood vessels (the vascular endothelium), making the smooth vessel walls rough and creating small "wounds."
Accelerating "Pipe" Blockage: To repair these "wounds," your body initiates a series of reactions. However, at the same time, "debris" in the blood, such as bad cholesterol (low-density lipoprotein), is particularly prone to depositing on these rough, injured areas, much like scale adheres more easily to rough pipe walls. Over time, these deposits accumulate, forming plaques that harden and narrow the blood vessels. This is what we commonly refer to as "atherosclerosis."
Leading to Serious Consequences: Once blood vessels become narrowed, hardened, or even blocked, the problems become severe.
- If this occurs in the blood vessels supplying the heart (coronary arteries), it can lead to angina or myocardial infarction (heart attack).
- If it occurs in the blood vessels supplying the brain, it can lead to cerebral infarction (stroke).
- Furthermore, high uric acid itself often "teams up" with issues like high blood pressure, high blood lipids, diabetes, and obesity. These are all risk factors for cardiovascular disease, essentially "ganging up" to damage your vascular health.

Therefore, gout is far more than just joint pain; it is a systemic metabolic disease. Controlling uric acid is not merely about alleviating joint pain; it is also about protecting your heart and brain, and about "clearing" and "maintaining" the "pipes" throughout your entire body.