Obesity, hypertension and diuretic use as risk factors for incident gout: a systematic review and meta-analysis of cohort studies

Abstract

BackgroundGout treatment remains suboptimal. Identifying populations at risk of developing gout may provide opportunities for prevention. Our aim was to assess the risk of incident gout associated with obesity, hypertension and diuretic use.MethodsWe conducted a systematic review and meta-analysis of prospective and retrospective cohort studies in adults (age ≥ 18 years) from primary care or the general population, exposed to obesity, hypertension or diuretic use and with incident gout as their outcome.ResultsA total of 9923 articles were identified: 14 met the inclusion criteria, 11 of which contained data suitable for pooling in the meta-analysis. Four articles were identified for obesity, 10 for hypertension and six for diuretic use, with four, nine and three articles included respectively for each meta-analysis. Gout was 2.24 times more likely to occur in individuals with body mass index ≥ 30 kg/m2 (adjusted relative risk 2.24 (95% confidence interval) 1.76–2.86). Hypertensive individuals were 1.64 (1.34–2.01) and 2.11 (1.64–2.72) times more likely to develop gout as normotensive individuals (adjusted hazard ratio and relative risk respectively). Diuretic use was associated with almost 2.5 times the risk of developing gout compared to no diuretic use (adjusted relative risk 2.39 (1.57–3.65)).ConclusionsObesity, hypertension and diuretic use are risk factors for incident gout, each more than doubling the risk compared to those without these risk factors. Patients with these risk factors should be recognised by clinicians as being at greater risk of developing gout and provided with appropriate management and treatment options.

Injection Techniques for Common Chronic Pain Conditions of the Foot: A Comprehensive Review

“…The four phases of the disease course are asymptomatic hyperuricemia, acute gouty attack, an intercritical period, and chronic tophaceous gout [51]. Risk factors include increased age, purine-rich diet including high consumption of meat and alcohol, obesity, hypertension, diabetes, and genetic predisposition [50,51,53]. In the United States, the prevalence is 3.9% among adults with men more affected than women [54].…”

Risk factors for prehypertension and their interactive effect: a cross- sectional survey in China

“…Elevated blood pressure is a common and serious public issue [ 1 , 2 ], which was significantly related to incidence of gout [ 3 ], Parkinson’s disease [ 4 ] and even prognosis in patients with systemic lupus erythematosus [ 5 ]. In 2003, the definition of prehypertension was first proposed in the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) [ 6 ].…”

Injection Techniques for Common Chronic Pain Conditions of the Hand: A Comprehensive Review

“…Hand complications include subcutaneous tophi, bone and joint damage, tenosynovitis of the finger flexors, and nerve compression [55]. The incidence of gout has increased significantly in the US and Europe over the last few decades likely secondary to increased longevity and overall diet and lifestyle change among the general population [56][57][58][59][60]. Among men, gout is the most common inflammatory joint condition [56,58].…”

“…Modifiable risk factors for gout include obesity, metabolic syndrome, and hypertension. Additionally, diuretic use and consumption of animal purines, alcohol, and fructose are significant risk factors [57,58,60]. The diagnosis of gout is initiated clinically and confirmed with the visualization of needle-shaped, negatively birefringent urate crystals on joint aspiration [61].…”