A clear link has been found between episodes of gout and risk of heart attack or stroke shortly afterwards.
Researchers, led by Professor Abhishek Abhishek at the University of Nottingham, UK, examined the possible link by looking at figures on 62,574 NHS patients treated for gout.
Among these patients, 10,475 experienced heart attack or stroke within the next four months.
Patients with gout were twice as likely to have had a gout flare in the 60 days before heart attack or stroke, once risk factors including comorbidities, socioeconomic deprivation, lifestyle factors and prescribed medications were taken into account.
The heart attack or stroke risk among gout patients remained higher – one and a half times the normal rate – in the 61-120 days after a flare.
Details appeared yesterday in JAMA. The authors say these findings further strengthen the evidence that gout flares are associated with a transient increase in cardiovascular events.
Professor Abhishek said: “This is the first study of its kind to examine whether there is an association between recent gout flares and heart attacks and strokes.
“People with recurrent gout flares should be considered for long-term treatment with urate lowering treatments such as allopurinol. This is a reliable way of removing urate crystal deposits and providing freedom from gout flares.
"Patients should also be considered for concurrent treatment with anti-inflammatory medicines such as colchicine for the first few months because urate lowering treatments may trigger gout flares in the short term.”
He added: “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 minimise their background risk of heart attack and stroke.”
Cipolletta, E. et al. Association Between Gout Flare and Subsequent Cardiovascular Events Among Patients With Gout. JAMA 2 August 2022 doi: 10.1371/journal.pbio.3001704
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