A critical survey of the literature suggests that elevated serum uric acid is definitely associated with hypertension and may function as an independent risk factor in the development of this disease. The possible role of an elevated serum uric acid as an independent risk factor for the development of ischemic heart disease remains controversial and the association of these two factors may depend on the relationship between uric acid and hypertension. There is no evidence available to define the metabolic turnover of uric acid in hypertensives. The exact mechanisms underlying elevated serum uric acid values during diuretic treatment are unclear, but depend initially upon diuretic-induced extracellular volume depletion.