In a large longitudinal study of 1,999 patients with rheumatoid arthritis (RA) in the USA, the prevalence of gout (6.1%) and hyperuricaemia (17%) was similar to previous estimates of these conditions in the general population. The coexistence of hyperuricaemia or gout in patients with RA was not associated with RA disease activity or severity. However, moderate hyperuricaemia in these patients was strongly associated with an increased risk of cardiovascular-disease-related mortality, which was driven by the presence of other comorbidities.