Objective. Despite the recent doubling of the incidence of gout among women and its substantial prevalence particularly in the aging female population, the risk factors for gout among women remain unknown. We undertook this study to evaluate purported risk factors for incident gout among women and to compare them with those among men.Methods. Using prospective data from the Framingham Heart Study, we examined over a 52-year period ) the relationship between purported risk factors and the incidence of gout in 2,476 women and 1,951 men.Results. We documented 304 incident cases of gout, 104 of them among women. The incidence rates of gout for women per 1,000 person-years according to serum uric acid levels of <5.0, 5.0-5.9, 6.0-6.9, 7.0-7.9, and >8.0 mg/dl were 0.8, 2.5, 4.2, 13.1, and 27.3, respectively (P for trend < 0.0001). The magnitude of this association was lower than that among men (P for interaction ‫؍‬ 0.0002). Multivariate relative risks conferred by increasing age (per 5 years), obesity (body mass index >30 kg/m 2 ), alcohol intake (>7 ounces of pure alcohol/week), hypertension, and diuretic use were 1.24, 2.74, 3.10, 1.82, and 2.39, respectively (all P < 0.05), for women.Conclusion. These prospective data with longterm followup provide evidence that higher levels of serum uric acid increase the risk of gout in a graded manner among women, but the rate of increase is lower than that among men. Increasing age, obesity, alcohol consumption, hypertension, and diuretic use were associated with the risk of incident gout among women.Gout, a common and excruciatingly painful inflammatory arthritis (1), has historically been considered a male disease, and most gout research has focused on men (2-9). However, growing evidence suggests a substantial disease burden of gout among older women, whose representation in the general population has grown with increasing longevity. The prevalence of self-reported physician-diagnosed gout based on the Third National Health and Nutrition Examination Survey (NHANES-III) was 3.5% in women ages 60-69 years, 4.6% in women ages 70-79 years, and 5.6% in women ages Ն80 years (10). The incidence of gout has doubled among women over the past 20 years, according to the Rochester Epidemiology project study (11). Despite this substantial and increasing disease burden, the risk factors for gout among women remain unknown.Given the significant role of estrogen in serum uric acid levels as well as the substantial sex difference in the incidence of gout and perhaps in uric acid metabolism (12), extrapolation of data on the risk factors for gout from men to women should be done with caution. The serum uric acid level, which is the most prominent predictor and precursor of gout, has been prospectively studied in relation to the risk of incident gout among men (2), but no corresponding data among women are

Objective. To determine the risk of cardiovascular disease (CVD) among osteoarthritis (OA) patients using populationbased administrative data from British Columbia, Canada. Methods. The medical history of a random sample of 600,000 individuals from 1991-2009 was analyzed. A total of 12,745 OA cases and up to 3 non-OA individuals matched by age, sex, and year of diagnosis were followed for CVD events. Cox proportional hazards and Poisson regression models were used to estimate the relative risks (RRs) of CVD, myocardial infarction, ischemic heart disease (IHD), congestive heart failure (CHF), and stroke after adjusting for available sociodemographic and medical factors. Results. OA was an independent predictor of CVD. The adjusted RRs were 1.15 (95% confidence interval [95% CI] 1.04 -1.27), 1.26 (95% CI 1.13-1.42), and 1.17 (95% CI 1.07-1.26) among older men, younger women, and older women, respectively. Analyses were stratified by age and sex due to statistically significant interactions between OA and age and sex. RRs among older men, younger women, and older women were 1.33 (95% CI 1.11-1.62), 1.66 (95% CI 1.37-2.01), and 1.45 (95% CI 1.22-1.72) for IHD, respectively, and 1.25 (95% CI 1.02-1.54), 1.29 (95% CI 1.00 -1.68), and 1.20 (95% CI 1.03-1.39) for CHF, respectively. Compared to non-OA individuals, OA cases who underwent total joint replacements had a 26% increased risk of CVD. Conclusion. This prospective longitudinal study suggests that OA is associated with an increased risk of CVD. Older men and adult women with OA had a higher risk of CVD, particularly IHD and CHF. Further studies are needed to confirm these results and to elucidate the potential biologic mechanisms.

GCs are associated with an increased risk of MI in RA. Our results suggest a dual effect of GCs on MI risk, an immediate effect mediated through current dosage and a long-term effect of cumulative exposure.