Uric acid is a known risk factor for both hypertension and heart disease. Many epidemiological studies show a link between uric acid and coronary disease, including stroke and heart attack. With higher levels of uric acid in the body, it creates an environment for painful gout flares. And those who have gout are more likely to have heart health issues–including heart disease, blocked arteries and heart failure. Left untreated, gout can be very dangerous, with new research showing that having gout doubles a person’s risk for heart attack or stroke.

According to the American Heart Association (AHA), studies show that people with high blood pressure have an increased risk of developing gout. And people with gout have an increased risk of developing high blood pressure. The AHA estimates that almost half of all Americans will develop high blood pressure by age 65. And the rate of gout attacks is increasing in the U.S., according to the Centers for Disease Control and Prevention (CDC).

So what does this mean? If you’re at risk for high blood pressure or heart disease, it’s important to keep your uric acid levels in check as part of your overall healthcare routine.

Gout is a painful form of arthritis that affects more than 6 million Americans. If you have gout, you are twice as likely to have heart problems, and this risk increases with every flare-up.

It turns out that gout can be dangerous to your heart in two ways: First, it is a known risk factor for both hypertension and heart disease. Many epidemiological studies show a link between uric acid and coronary disease, including stroke and heart attack. Second, with higher levels of uric acid in the body, it creates the environment for painful gout flares. And those who have gout are more likely to have heart health issues–including heart disease, blocked arteries and heart failure. Left untreated, gout can be very dangerous, with new research showing that having gout doubles a person’s risk for heart attack or stroke.

You may have heard that gout is a painful form of arthritis. You might have also heard that gout has been linked to kidney stones and heart disease.

But you might not know why.

And there’s a good reason for that:

It’s not exactly common knowledge that the reason gout and heart disease are linked is because of uric acid levels in your blood.

Uric acid is a byproduct of purine metabolism and is normally excreted in the urine. But sometimes, this doesn’t happen. And when uric acid builds up, it can crystallize in the joints, ligaments, and elsewhere — creating excruciating pain, inflammation, and stiffness.

But it also causes bigger problems, like hypertension (high blood pressure) and heart disease including stroke and heart attack. Now new research shows that having gout doubles a person’s risk for heart attack or stroke.

Uric acid is a byproduct of purine, a substance that naturally occurs in the body and is also found in certain foods. While eating things like red meat, organ meats and shellfish raises uric acid levels, some people have a genetic predisposition to too much uric acid production. This can lead to painful flares of gout.

Having high uric acid levels also raises your risk for heart disease. In fact, new research shows that people with gout are twice as likely to have a heart attack or stroke compared with someone who doesn’t have it.

While the exact link between gout and heart disease isn’t known yet, doctors think it could be because having high uric acid levels makes you more sensitive to insulin—and can lead to hypertension and other risk factors of heart disease.

If you have gout, talk with your doctor about whether medicine is necessary to help lower your risk for painful flares and long-term health issues like heart disease or stroke.