Obesity, hypertension, and diuretic use more than double the risk of incident gout, according to a recent British study.
Gout affects 2.5% of adults in the UK, with prevalence and incidence continuing to rise. Though the magnitude of the risk varies between studies, body mass index (BMI) and hypertension have previously been identified as risk factors for incident gout in a large number of epidemiological studies. Diuretics raise serum uric acid levels and are perhaps the most well-known medications to be associated with gout; however, it has been proposed that the observed risk results from comorbidities rather than diuretic use alone. Treatment of gout remains suboptimal; thus, identifying populations at risk may provide opportunities for primary prevention.
Led by Peter L. Evans of the Research Institute for Primary Care and Health Sciences at Keele University in Staffordshire, UK, and published in Arthritis Research & Therapy, this systematic review of cohort studies aimed to derive pooled estimates of the risk of incident gout associated with obesity, hypertension, and diuretic use.1
Researchers searched MEDLINE, Embase, CINAHL, and the Cochrane Library from their inception to March 2017 for cohort studies, prospective or retrospective, and undertaken in primary care or the general population, focusing on adults aged 18 years or older. Articles were required to have examined at least one of the following: obesity (BMI 30 ≥ kg/m2), hypertension (self-reported, physician-diagnosed, or study-defined mm Hg value), or diuretic use (self-reported or reported in records) and their association with incident gout, defined as the first recorded episode (ie, a subsequent new diagnosis of gout).
1. Evans PL, Prior JA, Belcher J, et al. Obesity, hypertension and diuretic use as risk factors for incident gout: a systematic review and meta-analysis of cohort studies. Arthritis Res Ther. Published online July 5, 2018. DOI: 10.1186/s13075-018-1612-1.