Gout can increase risk of cardiovascular diseases

Gout is always thought of as a joint condition because the classic symptom is almost unbearable pain in a joint, usually the big toe. But can the heart be involved in gout, too?

A study, led jointly by researchers from the Universities of Oxford, Glasgow, and KU Leuven in Belgium, reveals that gout is actually linked to an increased risk of a whole raft of cardiovascular diseases.

Examining the health records of more than 860,000 people has shown that having gout is accompanied by a 58% higher risk of cardiovascular disease, with even higher risks in women and those under the age 45.

Gout is caused by a build-up of uric acid in the body leading to tiny crystals forming around joints. It is more common in men and older people, but can impact women and younger people too.

To see how wide that range of diseases is, a large-scale study by UK and European researchers, using electronic health records from the Clinical Practice Research Datalink, analysed the data from more than 152,000 people with gout, alongside more than 700,000 matched controls. It turns out, women with gout have an 88% higher risk of cardiovascular disease compared to women without gout.

For men with gout, the risk of cardiovascular disease is 49% higher compared to those without gout.

Furthermore, a young person with gout has more than twice the risk of cardiovascular disease than one without gout. This increased risk was seen across all 12 cardiovascular diseases studied, including heart failure, ischaemic heart disease, arrythmias, valve disease and venous thromboembolism.

In addition, patients with gout had a higher BMI than matched controls, and a notably higher prevalence of other health conditions, such as chronic kidney disease and high blood pressure.

Lead senior author Dr Nathalie Conrad of KU Leuven, and Oxford University honorary research fellow, points to a large body of evidence that gout as well as other inflammatory conditions is rarely considered in cardiovascular disease prevention, nor are there specific preventive measures for these patients.

She believes this needs to change and that cardiovascular disease becomes an integral part of gout management.

First author of the paper, Dr Lyn D Ferguson, consultant and honorary senior clinical lecturer based at the University of Glasgow, said: “This work highlights the importance of screening for and managing a range of cardiovascular diseases in people with gout.

“Gout could be considered a metabolic condition and management should include addressing the heart and body weight alongside joints.”

‘‘ Management could include addressing the heart and weight