A multitude of studies, in an effort to explain how hyperuricemia can lead to hypertension and cardiovascular disease, have proposed interlinked mechanisms such as endothelial dysfunction and reduction in endothelial nitric oxide (NO) levels [35], oxidative stress [36], activation of the renin-angiotensin-aldosterone-system (RAAS) [37] and renal microvascular lesions [38]. Here, REN is linked to endothelial dysfunction.