Patients with a first diagnosis of gout at age 40 years or younger frequently had cardiovascular riskfactors and were less likely to achieve an sUA level less than 6.0 mg/dl compared with patients over 40years of age who were treated in routine clinical practice. Clinicians should be aware that patients withearly‐onset gout may be an undertreated population with poor adherence to ULT and increased risk ofrecurrent gout and cardiovascular diseases.