Gout Flare-ups May Increase Risk of Heart Attack

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Gout is a type of arthritis caused by high levels of uric acid in the body. FG Trade/Getty Images
  • Gout is a painful type of arthritis that is centered in one or more joints.
  • The condition is caused by high levels of uric acid in a person’s body.
  • Researchers say a person with gout is more likely to have a heart attack or stroke within 60 days of a flare-up.

Gout, a type of arthritis, was once known as the “disease of kings” because of the extravagant diet and alcohol consumption of such royalty as King Henry VIII, who famously suffered from it.

However, for those who have gout, there is nothing royal about it.

The disease is often accompanied by pain, swelling, redness, and tenderness in one or more joints, mostly in the big toe.

Researchers already know that multiple complications can occur in people who have gout — everything from joint damage to bursitis to bone loss to kidney damage.

Now, a study published today by the University of Nottingham in the United Kingdom reports that the risk of heart attacks and strokes temporarily increases in the four months after a gout flare.

The research, in collaboration with experts at Keele University, showed that people with gout who had a heart attack or stroke were twice as likely to have had a gout flare in the 60 days prior to the event. They were also one and a half times more likely to have a gout flare in the 61 to 120 days prior.

“This is the first large study to look at whether gout flares are linked with an increased risk of heart attack and stroke,” Abhishek Abhishek, PhD, the study’s lead author and a professor of rheumatology at the School of Medicine at the University of Nottingham, told Healthline.

Abhishek and his colleagues used anonymized data from 62,574 people with gout who were treated in the National Health Service in the United Kingdom.

Of these, 10,475 experienced a heart attack or stroke after their diagnosis of gout while others of similar age, sex, and duration of gout, did not experience such events.

The researchers evaluated the association between heart attacks or strokes and recent gout flares and adjusted these results for comorbidities, socioeconomic deprivation, lifestyle factors, and prescribed medications among other things.

“The results show that among patients with gout, patients who experienced a heart attack or stroke had significantly increased odds of a gout flare during the preceding 120-days compared with patients who did not experience such events,” Abhishek said in a press statement.

“These findings suggest that gout flares are associated with a transient increase in cardiovascular events following flares,” he added.

Abhishek explained that people with recurrent gout flares should be considered for long-term treatment with uric acid-lowering treatments such as allopurinol.

This therapy, he said, is a reliable way of removing urate crystal deposits and providing freedom from gout flares.

Other treatments for flares consist of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, steroids, and the anti-inflammatory drug colchicine, but there are side effects for some people.

Abhishek said that people with gout should be encouraged to “adopt a healthy lifestyle with appropriate treatment of conditions such as high blood pressure, high cholesterol, obesity, and diabetes to minimize their background risk of heart attack and stroke.”

According to the Centers for Disease Control and Prevention (CDC), there is no cure for gout. However, there are things you can do to keep gout at bay.

The CDC lists the following conditions as things that can increase the risk of gout:

  • Obesity
  • Congestive heart failure.
  • Hypertension (high blood pressure).
  • Insulin resistance, metabolic syndrome, and diabetes
  • Poor kidney function.
  • Using certain medications such as diuretics (water pills).
  • Drinking alcohol and eating or drinking food and drinks high in fructose (a type of sugar).

Gout is caused by high levels of uric acid, a chemical produced by the breakdown of tissues in the body and present in certain foods and drinks.

Purine compounds can raise uric acid levels, according to the Arthritis Foundation.

Excess uric acid can produce uric acid crystals, which then build up in soft tissues and joints, causing the painful symptoms of gout.

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