Excess Cardiovascular Risk in Gout Save

A UK population cohort study has shown that gout carries an increased risk for a wide variety of cardiovascular disorders.

A matched case–control study examined the electronic health records from the UK Clinical Practice Research Datalink and compared gout (one to five) with controls matched for age, sex, socioeconomic status, geographical region, and calendar, to look a the incidence of 12 cardiovascular diseases.

A total of 152 663 gout patients were compared to 709 981 matched controls demonstrating a higher incidence of CV disease in gout (20.6%) compared to controls (15%) with an increased (HR 1·58; 95% CI 1·52–1·63). Gout patients developed CV disease after a median follow-up of 6·5 years.

Excess CV risk extended beyond atherosclerotic disease and included an increased risk of heart failure, arrhythmias, valve disease, and thromboembolic diseases.

Cardiovascular risk in gout was significantly higher in women (HR 1·88), and younger individuals (<45 years: HR 2·22). Gout patients had a significantly higher BMI and higher prevalence of chronic kidney disease, dyslipidemia, history of hypertension, obesity, and type 2 diabetes. Adjusting for known cardiovascular risk factors attenuated but did not eliminate the excess risk of cardiovascular disease related to gout (adjusted HR 1·31).

Strategies are needed to reduce cardiovascular risk in patients with gout.