Increased risk of vascular disease associated with gout: a retrospective, matched cohort study in the UK Clinical Practice Research Datalink

Abstract

ObjectivesTo determine whether gout increases risk of incident coronary heart disease (CHD), cerebrovascular (CVD) and peripheral vascular disease (PVD) in a large cohort of primary care patients with gout, since there have been no such large studies in primary care.MethodsA retrospective cohort study was performed using data from the Clinical Practice Research Datalink (CPRD). Risk of incident CHD, CVD and PVD was compared in 8386 patients with an incident diagnosis of gout, and 39 766 age, sex and registered general practice-matched controls, all aged over 50 years and with no prior vascular history, in the 10 years following incidence of gout, or matched index date (baseline). Multivariable Cox Regression was used to estimate HRs and covariates included sex and baseline measures of age, Body Mass Index, smoking, alcohol consumption, Charlson comorbidity index, history of hypertension, hyperlipidaemia, chronic kidney disease, statin use and aspirin use.ResultsMultivariable analysis showed men were at increased risk of any vascular event (HRs (95% CIs)) HR 1.06 (1.01 to 1.12), any CHD HR 1.08 (1.01 to 1.15) and PVD HR 1.18 (1.01 to 1.38), while women were at increased risk of any vascular event, HR 1.25 (1.15 to 1.35), any CHD HR 1.25 (1.12 to 1.39), and PVD 1.89 (1.50 to 2.38)) but not any CVD.ConclusionsIn this cohort of over 50s with gout, female patients with gout were at greatest risk of incident vascular events, even after adjustment for vascular risk factors, despite a higher prevalence of both gout and vascular disease in men. Further research is required to establish the reason for this sex difference.

Gout is associated with organic and psychogenic erectile dysfunction

“…Gout is an inflammatory response that can increase the risk of cardiovascular disease [15][16][17], and it is as a stressful factor for affected individuals, both reasons may cause development of ED [18]. Based on the findings of these studies, a relationship between gout and ED may exist [19].…”

Factors Influencing Allopurinol Initiation in Primary Care

“…These patients were originally the gout cohort of a larger retrospective matched-cohort study investigating gout and risk of vascular disease. 4 All patients having gout in that study were eligible for this analysis, but 244 patients were excluded because of missing prescription data, resulting in a study population of 8,142 gout patients. Patients were older than 50 years with an incident diagnosis of gout between 1987 and 1999 to allow 10 years of follow-up.…”

Epidemiology and health-related services

“…Nevertheless, several recent studies have once again linked gout with cardiovascular outcomes [54], cardiovascular mortality [55], and myocardial infarction [56]. Interestingly, cardiovascular outcomes have been considered to be the main determinants of costs in gout [57].…”