Gout is the most common rheumatic disease in the adult population. Hypertension is one of the most common comorbidities of gout. The combination of hypertension with metabolic abnormalities is the great importance. In patients with hypertension the high uric acid is an independent predictor of increased risk of cardiovascular events (including fatal cardiac events), and overall mortality. The review considers the pathogenic mechanisms by which uric acid participate in the development and progression of cardiovascular diseases, including hypertension, and the analysis of antihypertensive therapy in patients with gout.