The Effect of Allopurinol on the Risk of Cardiovascular Events in Patients with Cardiovascular Risk

Inclusion Criteria:

1. Age: between 40-70 years old.

2. Giving informed consent to participate in the study.

3. Serum UA levels above 5 mg/dl within the last six months before the screening visit.

4. Meeting at least one of the criteria defining high or very high CV risk includes:

5. calculated 10-year cardiovascular mortality risk based on SCORE2 >2.5% forpatients under 50 years old or ≥5% for patients 50 years old or older

6. documented occurrence of CV diseases (cerebrovascular disease: ischemic stroke,intracerebral bleeding, TIA; heart failure regardless of the etiology NYHA I -II (without IHD), PAD, atrial fibrillation (de novo or ever)

7. diabetes or arterial hypertension complicated by organ damage:

• increase in vascular stiffness: pulse pressure ≥ 60 mmHg, and/orcervicofemoral PWV > 10 m/s;
• features of left ventricular hypertrophy on echocardiography orelectrocardiography;
• increased urine albumin-creatinine ratio (30-300 mg/g);
• ankle-brachial index < 0.9.

Exclusion Criteria:

1. Taking allopurinol, febuxostat or other hypouricemic drugs.

2. Contraindications to taking allopurinol.

3. Pregnant women, breastfeeding or planning pregnancy during the duration of thestudy.

4. Hormonal therapy containing oestrogens.

5. Active cancer process or disease in the last five years, excluding locally malignanttumours.

6. Uncontrolled hypertension (mean value ≥ 180/110 mmHg seven days before screeningvisit) in home measurements despite using hypotensive drugs.

8. Renal insufficiency with an eGFR <45 ml/ min/1.73m2 (according to 2009 CKD-EPIrecommendations: stage G3b, G4 and G5).

9. Hypothyroidism or hyperthyroidism not in a state of euthyroidism.

10. Confirmed coronary artery disease (defined as prior AMI, revascularization of themyocardium, confirmed presence of atherosclerotic plaques in coronary arteries onimaging studies).

11. Heart failure in NYHA class III and IV.

12. Taking preparations: azathioprine, mercaptopurine or cyclosporin. Participation inanother clinical trial of a medicinal product or medical device within the lastthree months or five half-lives, whichever period is longer.