Gout and coronary heart disease: The framingham study

Abbott, Robert D.; Brand, Frederick N.; Kannel, William B.; Castelli, William P.

doi:10.1016/0895-4356(88)90127-8

Cited by 320 publications

(220 citation statements)

References 22 publications

Supporting

Mentioning

202

Contrasting

Unclassified

Order By: Relevance

“…Both studies report an ≈60% increase in coronary heart disease or cardiovascular mortality in men with gout, but not in women, regardless of traditional risk factors or diuretic medications. The survey also revealed a gradual increase in cardiovascular mortality dependent on blood uric acid levels 5, 6. In line with this, a prospective study of the Health Professionals Follow‐Up Study confirmed these data by also revealing an ≈60% increase in the risk of fatal coronary heart disease in men with diagnosed gout and a history of CVD 3.…”

Section: Introductionsupporting

confidence: 62%

Gouty Offense in Patients With Obstructive Coronary Artery Disease Despite State‐of‐the‐Art Therapy

Döring

Vorst

2018

JAHA

View full text Add to dashboard Cite

Section: Introductionsupporting

confidence: 62%

Gouty Offense in Patients With Obstructive Coronary Artery Disease Despite State‐of‐the‐Art Therapy

Döring

Vorst

2018

JAHA

View full text Add to dashboard Cite

“…8 In the Framingham cohort, subjects with hypertension have been noted to have a 3-fold increased risk of gout. 9 A more recent 4-year study from the same cohort showed that hyperuricemia preceded onset of hypertension. 13 The magnitude of risk that they observed (odds ratio: 1.17 for each increase in serum uric acid by 1.3 mg) is comparable to our findings.…”

Section: Discussionmentioning

confidence: 99%

“…The link between hyperuricemia and hypertension has been reported in several studies. [5][6][7][8][9][10][11][12][13]16,17 Among children newly diagnosed with hypertension, serum uric acid was highly correlated with both systolic and diastolic blood pressure. 8 In the Framingham cohort, subjects with hypertension have been noted to have a 3-fold increased risk of gout.…”

Section: Discussionmentioning

confidence: 99%

Hyperuricemia and Incidence of Hypertension Among Men Without Metabolic Syndrome

et al. 2007

View full text Add to dashboard Cite

Abstract-The aim of this project was to study the risk of developing hypertension over a 6-year follow-up in normotensive men with baseline hyperuricemia (serum uric acid Ͼ7.0 mg/dL) but without diabetes/glucose intolerance or metabolic syndrome. We analyzed the data on men without metabolic syndrome or hypertension at baseline from the Multiple Risk Factor Intervention Trial. These men (nϭ3073; age: 35 to 57 years) were followed for an average of 6 years by annual examinations. Follow-up blood pressure among those with baseline was consistently higher than among those with normal serum uric acid concentration. We used Cox regression models for adjustment for the effects of serum creatinine, body mass index, age, blood pressure, proteinuria, serum cholesterol and triglycerides, alcohol and tobacco use, risk factor interventions, and use of diuretics. In these models, normotensive men with baseline hyperuricemia had an 80% excess risk for incident hypertension (hazard ratio: 1.81; 95% CI: 1.59 to 2.07) compared with those who did not. Each unit increase in serum uric acid was associated with a 9% increase in the risk for incident hypertension (hazard ratio: 1.09; 95% CI: 1.02 to 1.17). We conclude that the hyperuricemia-hypertension risk relationship is present among normotensive middle-aged men without diabetes/glucose intolerance or metabolic syndrome. in Ϸ3.9 million ambulatory care visits annually. 1,2 Many more have asymptomatic hyperuricemia, a risk factor for gout and for higher cardiovascular risk. 3 Hypertension is also very common, affecting Ϸ1 in every 4 adults. 4 Among those with prehypertension, those in the highest uric acid quartile were at Ͼ2 times greater risk for microalbuminuria than those in the lowest quartile, but this relationship was not found among normotensive subjects. 5 Animal and human studies have repeatedly shown a statistically independent association between serum uric acid and risk for hypertension. 6 -13 In a recent review, Johnson et al 8 have marshaled evidence that fulfills all of the Bradford Hill criteria for causality. 14 However, the issue of causality has been challenged. Skeptics cite studies that point to the strong coincidence of other cardiovascular risk factors, such as metabolic syndrome as a whole and its individual components as potential confounders. [15][16][17] Furthermore, many studies have linked a single baseline measurement of serum uric acid to onset of hypertension many years later: a limitation considering the fact that hyperuricemia, not necessarily a "trait," like serum cholesterol, can fluctuate up and down over time in response to common environmental changes such as diet, medications, and so forth.One way to overcome the above limitations would be to assemble a cohort of subjects who are at risk for hypertension but not hypertensive (thereby affording statistical power to detect small risk differences) and free of renal disease, diabetes, and metabolic syndrome. These individuals should then be followed over time with several repeated measures of ...

show abstract

“…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)(4)(5)(6)(7)(8)(9)(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).…”

mentioning

confidence: 99%

Racial differences in the incidence of gout

Hochberg

Thomas

et al. 1995

Arthritis & Rheumatism

122

View full text Add to dashboard Cite

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

show abstract

Gout and coronary heart disease: The framingham study

Cited by 320 publications

References 22 publications

Gouty Offense in Patients With Obstructive Coronary Artery Disease Despite State‐of‐the‐Art Therapy

Gouty Offense in Patients With Obstructive Coronary Artery Disease Despite State‐of‐the‐Art Therapy

Hyperuricemia and Incidence of Hypertension Among Men Without Metabolic Syndrome

Racial differences in the incidence of gout

Contact Info

Product

Resources

About