Urate Lowering Therapies and Left Ventricular Diastolic Dysfunction

Inclusion Criteria (all of the four criteria) 1. Aged between 40-75 years 2. Metabolic syndrome 3. Hyperuricemia, defined as a serum uric acid level of 7 mg/dl or more in men or 6 mg/dl or more in females, with a history of hyperuricemia within a year; or a serum uric acid level of 8 mg/dl or more in men or 7 mg/dl or more in females and it is hardly expected to be modified by dietary control; or persistent hyperuricemia after dietary control for 3 months 4. Not take any of urate-lowering therapies (benzbromarone, allopurinol, or febuxostat) Exclusion Criteria: 1. pregnancy 2. hypersensitivity to febuxostat or benzbromarone 3. acute gout 4. a history of urinary tract stone 5. chronic kidney disease stage IV or V 6. valvular heart disease with moderate or severe regurgitation 7. left ventricular ejection fraction of 40% or less 8. hypertrophic cardiomyopathy or dilated cardiomyopathy or infiltrative cardiomyopathy or constrictive cardiomyopathy 9. a history of congenital heart disease 10. a history of pulmonary hypertension 11. chronic atrial fibrillation or significant arrhythmia 12. a history of intracardiac device implantation 13. uncontrolled hypertension (systolic blood pressure \> 160mm Hg or diastolic blood pressure \> 100 mm Hg) 14. alanine Aminotransferase \> 3 times upper limit) 15. acute infection 16. suspected or diagnosed with malignancy 17. a history of autoimmune disease 18. limited to or dependent on daily activities 19. life expectancy less than a year 20. Acute coronary syndrome or received a percutaneous coronary intervention or received a coronary artery graft bypass surgery or stroke within 3 months 21. Diabetes with insulin treatment or glucagon-like peptide 1 receptor agonist treatment 22. Anemia (hemoglobin \< 11 mg/dl in mem or \<10mg/dl in women)