This review discussed UA’s role in causing arterial stiffness and inflammation which is NLRP3 inflammasome dependent and is activated through AMPK-mTOR-mROS and HIF-1α. Cardiomyocytes with hyperuricemia exhibit insulin resistance due to the activation of the ROS-IRS1/Akt phosphorylation pathway and are positively correlated with the various components of MetS. Moreover, febuxostat effectively improves cardiovascular events as compared to allopurinol. This evidence concerns the gene AKT1 and hyperuricemia.