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Objective: Several drugs can cause hyperuricemia including low-dose aspirin (LDA), which is commonly prescribed for primary prevention of cardiovascular disease. The effect of LDA on serum uric acid (SUA) level in asymptomatic hyperuricemia patients needed exploration. The authors' aim was to determine the prevalence of a significant change in the SUA level and onset of any new acute gouty attack in asymptomatic hyperuricemia patients with cardiovascular risk factors as indicated by taking LDA. Materials and Methods: An experimental study was performed in 128 Thai asymptomatic hyperuricemia patients with cardiovascular risks at Srinagarind Hospital, Khon Kaen University, Thailand, between October 2016 and October 2017. Both clinical and laboratory assessments were performed before and after taking LDA for 2 weeks. Results: Data analysis was performed on the 120 patients who completed the present study. Seven patients were excluded because of being lost to follow-up, and another was withdrawn because of having an acute gouty attack. The mean SUA level at baseline was 7.5 mg/dl. After 2 weeks of LDA, 75.8% of the participants had a significantly decreased SUA level. Only 4.2% of participants had an increased SUA level. One of our participants experienced an acute gouty attack at the first metatarsophalangeal joint after LDA initiation. Conclusion: The influence of 2 weeks of LDA on the SUA level was demonstrated in asymptomatic hyperuricemia patients with cardiovascular risks. The SUA level showed an unexpected, significant decrease in two-third of the study population, and less than 1% of the participants experienced an acute gouty attack after 7 days of aspirin initiation. [ABSTRACT FROM AUTHOR]