Analysis of serum uric acid (SUA) data obtained during the second examination of 2,530 persons in Evans County, Georgia, revealed a mean SUA level of 5.7 and 5.6 mg/100 ml for white and black males, respectively, and 4.8 and 4.9 mg/100 ml for white and black females, respectively. The SUA level and ponderal index were negatively correlated in all four race-sex groups. The prevalence of hypertension was greater in hyperuricemics as compared to normouricemics in all race-sex groups. Increased prevalence of coronary heart disease in hyperuricemics was secondary to increased body size. We review hypotheses concerning the relationships between SUA and coronary risk factors, hypertension, and coronary heart disease.