Of 124 asymptomatic hyperuricemic and 224 normouricemic subjects, none initially had gout, renal or cardiovascular disease, diabetes, or hypertension. After 50 months, eight hyperuricemic patients had hypertension; four, diabetes; two, heart disease; three, gout; one, urolithiasis. One initially normouricemic person developed gout; two, urolithiasis. Urinary infection rates were similar. In 32 subjects, serum creatinine levels were unchanged 1½ years before and 3 years after established hyperuricemia. Thus, cardiovascular disease and diabetes are more frequent consequences than renal disease or gout. Drug therapy for hyperuricemia itself appears unnecessary. Asymptomatic hyperuricemic patients had higher mean blood levels of hemoglobin, white blood cells, glucose, cholesterol, calcium, creatinine, and albumin, as well as higher weight, mean pulse rate, and systolic blood pressure. Larger percentages had blood group B, rheumatoid factor, and histories of hay fever, allergy to penicillin, and use of antihistamines in the previous year. Hyperuricemic patients had similar educations, occupations, and drinking