Objective. To estimate the incidence of and examine risk factors for the development of gout in black and white male physicians.Methods. Data from 2 cohorts of former medical students, 352 black men in the Meharry Cohort Study and 571 white men in the Johns Hopkins Precursors Study, were analyzed. Cases of gout were identified by self-report. Baseline variables and incident hypertension were examined as risk factors for the development of gout in both cohorts.Results. The incidence of gout was 3.11 and 1.82 per 1,000 person-years in the black men and the white men, respectively (P < 0.05); the cumulative incidence was 10.9% and 5.8%, respectively (P = 0.04). The relative risk (RR) for gout among the black men was Conclusion.The approximately 2-fold excess risk for gout among black men is explained, in part, by a greater risk of incident hypertension.Gout is the most common form of inflammatory arthritis in men aged 40 and older, with a prevalence approaching 5% (1). Data from the United States National Health Interview Survey indicate that the prevalence of gout and the morbidity associated with gout are greater in black men than in white men (2). Several longitudinal studies have estimated the incidence of and examined risk factors for gout (3-10). These studies, however, have been limited to whites in the United States and Europe; no data are available on the incidence of gout among blacks, and the only data on risk factors for gout in blacks are derived from a single case-control study (1 1).In the present study, we estimated the incidence of and examined potentially modifiable risk factors for gout in 2 cohorts of former medical students who matriculated at Meharry Medical College and The Johns Hopkins University School of Medicine and were followed up for 26-34 years. Black men had a 70% greater risk of developing gout than white men. This excess risk appears primarily related to the excess risk of developing incident hypertension in black men. These data suggest that intensive efforts directed toward both hypertension prevention and treatment of hypertension with either nonpharmacologic approaches or pharmacologic agents that don't produce secondary hyperuricemia may be effective in reducing the incidence of and morbidity from gout in black men. PATIENTS AND METHODSStudy populations. The Meharry-Hopkins Study is a collaborative activity between Meharry Medical College and

These results, in black and white male physicians, do not suggest a role in men for targeting gout identification in the primary prevention of CHD.

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