In India, cardiovascular diseases (CVDs) are estimated to be responsible for 1.5 million deaths annually. Indeed, it is estimated that by 2020, CVDs will be the largest cause of mortality and morbidity in India. Hypertension is a major risk factor for CVDs, including stroke and myocardial infarction, and its burden is increasing disproportionately in developing countries. It is estimated that around two-thirds of those with people with hypertension worldwide were living in developing countries (639 million) in 2000, and that this would rise to three-quarters living in developing countries (1.15 billion) by 2025. Uric acid builds up when the body makes too much of it, fails to excrete it or both. It is a metabolic product resulting from purine. It remains possible that uric acid is a marker for xanthine oxidase-associated oxidants and that the latter could be driving the hypertensive response. However, the evidence suggests that uric acid is a true modifying and possibly causal factor for human primary hypertension. Hence, early management of hyperuricemia might delay the development of essential hypertension.