Fact checked byShenaz Bagha

Read more

March 19, 2024
2 min read
Save

Cardiovascular disease risk in gout highest for women, young people

Fact checked byShenaz Bagha
You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Key takeaways:

  • Excess cardiovascular disease risk in patients with gout was highest among women and those aged younger than 45 years.
  • Higher risk in patients with gout persisted after adjusting for cardiovascular risk factors.

Excess risk for cardiovascular disease in patients with gout — including heart failure and arrhythmias — is highest among women and those aged younger than 45 years, according to data published in The Lancet Rheumatology.

“Although numerous studies have assessed the association of gout with atherosclerotic cardiovascular disease, fewer high-quality studies have assessed its association with other cardiovascular diseases, such as valve disease, venous thromboembolism, heart failure, pericarditis and infective endocarditis,” Lyn D. Ferguson, PhD, of the University of Glasgow, in Scotland, and colleagues wrote. “Filling this evidence gap is important, given that such cardiovascular outcomes have become more common in many high-income countries due to reductions in adverse atherosclerotic outcomes.”

An infographic showing the highest excess risk for cardiovascular disease in patients with gout among those younger than 45 years vs. woman or all patients.
Data derived from Ferguson LD, et al. Lancet Rheumatol. 2024;doi:10.1016/S2665-9913(23)00338-7.

To understand more about how cardiovascular disease risk in gout varies across specific conditions, Ferguson and colleagues conducted a matched case-control study of electronic health records from the U.K. Clinical Practice Research Datalink. The researchers selected patients aged 80 years or younger at the time of their first gout diagnosis between 2000 and 2017. Included patients were free of cardiovascular disease for up to 12 months afterward. Each patient was compared with up to five matched controls randomly selected from individuals free of gout.

The researchers examined the prevalence of aortic aneurysm, cardiac arrythmias, heart failure, ischaemic heart disease, myocarditis and pericarditis, peripheral arterial disease, infective endocarditis, stroke, valve diseases and venous thromboembolism or pulmonary embolism. The study included 152,663 patients with gout, 20.6% of whom developed cardiovascular disease over a median follow-up of 6.5 years, as well as 709,981 matched controls, 15% of whom developed cardiovascular disease.

According to the researchers, Cox proportional hazard models revealed excess risk among patients with gout across all cardiovascular diseases under investigation. Patients with gout demonstrated a higher risk for cardiovascular disease than controls (HR = 1.58; 95% CI, 1.52-1.63), particularly among women (HR = 1.88; 95% CI, 1.75-2.02) and those aged 45 years or younger (HR = 2.22; 95% CI, 1.92-2.57).

Adjusting for cardiovascular risk factors such as blood pressure, BMI and smoking status “attenuated but did not eliminate” excess risk for cardiovascular disease related to gout (adjusted HR = 1.31; 95% CI, 1.27-1.36), the researchers wrote.

Ferguson and colleagues concluded that the excess cardiovascular risk “appeared to be only partly explained by traditional cardiovascular risk factors.”

“As such, the addition of gout into routinely used cardiovascular risk scores, such as QRISK, and its inclusion in cardiovascular disease prevention guidelines appears warranted,” they added. “Strategies to reduce cardiovascular risk in patients with gout need to be further developed and implemented.”