July 30, 2018
4 min read
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Obesity, hypertension, diuretic use each double risk for gout

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Obesity, hypertension and the use of diuretics each represent independent risk factors for incident gout, individually associated with a twofold increase in risk, according to findings published in Arthritis Research & Therapy.

BMI and hypertension have been identified as risk factors for incident gout in a number of large epidemiological studies, yet the magnitude of risk varies between studies,” James A. Prior, PhD, MSc, of Keele University, Staffordshire, U.K., and colleagues wrote. “Diuretics are perhaps the most well-known medications to be associated with gout; they raise serum uric acid levels by increasing uric acid reabsorption and decreasing uric acid secretion in the kidneys. However, it has also been proposed that diuretic use alone does not increase the risk of gout and that the observed associated risk is due to the presence of comorbidities which they are used to treat; commonly hypertension, heart failure and renal failure.”

To determine the risk for incident gout linked with obesity, hypertension and diuretics, the researchers conducted a systematic review and meta-analysis of prospective and retrospective cohort studies. The researchers focused on studies of adults aged 18 years and older, from primary care or general populations, who had obesity or hypertension, or had used diuretics. In addition, the studies all had to include incident gout as an outcome.

Obesity, hypertension and the use of diuretics each represent independent risk factors for incident gout, according to findings.
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Prior and colleagues narrowed their search to 14 articles for their systematic review, and 11 for their meta-analysis. All included articles had sample sizes that ranged from 923 to 60,181. The number of incident gout cases in each study ranged from 43 to 1,341.

According to the researchers, gout was 2.24 times more likely to occur in patients with a BMI of 30 kg/m2 or greater (adjusted RR = 2.24; 95% CI, 1.76-2.86). In addition, patients with hypertension were more than twice as likely to experience incident gout (aRR = 2.11; 95% CI, 1.34-2.01) than those without hypertension. Individuals who had used diuretics had almost 2.5 times the risk for developing gout (aRR = 2.39; 95% CI, 1.57-3.65).

“Obesity, hypertension and diuretic use are all risk factors for incident gout, independent of one another and each more than doubling the risk of developing gout compared with those without these conditions,” Prior and colleagues wrote. “Such patients should be recognized by clinicians as being at greater risk of developing gout and provided with appropriate management and treatment options.” – by Jason Laday

Disclosure: Evans reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.