BACKGROUND: Hypertensive patients with increased serum uric acid (SUA) are at increased cardiovascular (CV) risks. Both the European and American hypertension guidelines endorse the utilization of 24h-ambulatory blood pressure monitoring (24h-ABPM) for hypertensive patients with increased CV risk. While there is difference in identifying UA as a CV risk factor between the European and American guidelines. Therefore, it is unknown whether 24h-ABPM should be used routinely in hypertensive patients with increased SUA. METHOD: To address this knowledge gap, we investigated 1) the correlation between SUA and 24h-ABP; 2) the association between SUA and BP phenotypes (controlled hypertension, white-coat uncontrolled hypertension [WCUH], masked uncontrolled hypertension [MUCH] and sustained uncontrolled hypertension [SUCH]); 3) the association between SUA and target organ damage (TOD: microalbuminuria, left ventricular hypertrophy [LVH] and arterial stiffness) according to BP phenotypes. RESULTS: In 1336 treated hypertensive patients (mean age 61.2 and female 55.4%), we found 1) there was no correlation between SUA and 24h, daytime, and nighttime SBP/DBP, respectively; 2) In reference to controlled hypertension, SUA increase was not associated WCUH (odds ratio [OR] 0.968, p=0.609), MUCH (OR 1.026, p=0.545) and SUCH (OR 1.003, p=0.943); 3) the overall prevalence of microalbuminuria, LVH and arterial stiffness was 2.3%, 16.7% and 23.2% respectively. After adjustment for covariates, including age, sex, smoking, body mass index, diabetes mellitus and estimated glomerular filtration rate, there was no association between SUA and TOD in all BP phenotypes. CONCLUSION: These preliminary findings did not support routine use of 24h-ABPM in treated hypertensive patients with increased SUA.