To determine the prevalence of metabolic syndrome and ischemic heart disease (IHD) in gout, 64 consecutive outpatients with primary gout but no previous history of IHD were included into the study and demographic and clinical data, resting EKG, lipid profile, fasting insulin and single photon emission computer tomography (SPECT) were recorded. Metabolic syndrome as defined by ATP III criteria was present in 82% of patients, all of whom had at least 1 metabolic abnormality; IHD as defined by EKG and/or SPECT was diagnosed in 16% of patients (n=10), all of whom had metabolic syndrome as well. Patients with IHD differed from those without IHD by percentage of HDL levels <40 mg/dL, by glucose and insulin levels in the fasting state and by low density lipoproteins. According to the authors, rheumatologists have an important role to play in the detection of metabolic syndrome and associated cardiovascular risk factors, as gouty patients tend to first seek help from rheumatologists.