Hyperuricemia is reportedly associated with the progression of carotid intima-media thickness (IMT), a surrogate of cardiovascular risks and events. However, factors associated with carotid IMT progression in patients with asymptomatic hyperuricemia are largely unknown. In this post-hoc analysis of the multicenter, randomized PRIZE study, we analyzed data from a total of 326 patients who underwent carotid ultrasonography in a blind manner at baseline and 24 months to evaluate carotid IMT. Mean and maximum IMT at the common carotid artery (CCA) were measured at a central core laboratory. Factors related to the absolute change in mean and maximum IMT from baseline to 24 months were explored. Overall, the adjusted mean [0.0032 (- 0.0214 to 0.0278) mm] and maximum [0.0011 (- 0.0327 to 0.0351) mm] CCA-IMT increased numerically from baseline to 24 months. Multivariable analysis identified higher body mass index, history of atherosclerotic cardiovascular disease (ASCVD), and lower mean CCA-IMT at baseline as significant factors associated with the increase in mean CCA-IMT. In addition, older age and lower mean CCA-IMT at baseline were significant factors for an increased absolute change in the maximum CCA-IMT at 24 months. The present sub-analysis of the PRIZE study showed higher body mass index, history of ASCVD, and older age as significant factors associated with CCA-IMT progression in patients with asymptomatic hyperuricemia. These factors may be considered when identifying the possible risk of atherosclerotic progression in this specific patient population of hyperuricemia.Trial registration: UMIN000012911 and UMIN000041322.

AT received honoraria from Boehringer Ingelheim and research funding from GlaxoSmithKline and Takeda. MM has received honoraria from Sanofi, Takeda Pharmaceutical Company Ltd., Eli Lilly Japan, Mitsubishi Tanabe Pharma Corporation, Astellas Pharma Inc., Novo Nordisk Pharma Ltd., Sumitomo Dainippon Pharmaceutical Company and MSD; research funding from Sysmex Corporation and Nissui; and subsidies or donations from Novartis Pharma, Sanofi, and Novo Nordisk Pharma Ltd. KN has received honoraria from MSD, Astella, AstraZeneca, Novartis Pharma, Ono Pharmaceutical, Daiichi Sankyo, Mitsubishi Tanabe Pharma, Eli Lilly Japan, Boehringer Ingelheim Japan, Takeda Pharmaceutical; Research grant from Asahi Kasei, Astellas, Mitsubishi Tanabe Pharma, Teijin Pharma, Terumo, Boehringer Ingelheim Japan, Eli Lilly and Company, Mochida Pharmaceutical, Fuji Yakuhin; Scholarship from Daiichi Sankyo Healthcare, Teijin Pharma, Medtronic, Bayer Yakuhin. All other authors declare no competing interests.