In this paper, Feig et al. review cardiovascular conditions and risk factors associated with elevated uric acid. They also discuss the recent experimental and clinical evidence supporting the possibility that an elevated uric acid level may lead to hypertension. Studies on the link between hyperuricemia and the development of hypertension are also presented. The proposed mechanism for uric acid-mediated hypertension is presented schematically. Finally, important limitations and caveats of recent studies on a causal role for uric acid in cardiovascular disease are reviewed.