Building on the foundational mechanistic and epidemiological knowledge from Part I, this second part of the review further unpacks the cardiovascular implications of abnormalities in serum levels of uric acid (UA). With a focus on hypertension, coronary artery disease (CAD), heart failure (HF), stroke, and peripheral artery disease (PAD), we provide a nuanced synthesis of how elevated serum UA influences disease risk and clinical outcomes.We describe mechanistic pathways including endothelial dysfunction, vascular smooth muscle proliferation, oxidative stress, inflammation, and renin–angiotensin system activation.
