Gout as a risk factor for myocardial infarction and stroke in England: evidence from record linkage studies

Seminog, Olena; Goldacre, Michael J

doi:10.1093/rheumatology/ket293

Cited by 89 publications

(82 citation statements)

References 34 publications

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“…A different study using the same dataset looking at MI incidence alone found an adjusted HR for MI of 1.23 in the gout group over an 8-year period, with even more pronounced risk in patients without traditional cardiovascular risk factors [21]. An analysis of retrospective analysis of hospital records from the entire UK found that patients who had been admitted to the hospital for gout flares were much more likely to be admitted to the hospital or die from an MI or stroke, with a relative risk (RR) of 1.82 for MI, 1.71 for stroke, with stronger associations seen in younger age groups and in women [22]. However, while this last study has a very impressive scope, it has the significant limitation of being unable to control for a number of potential confounders due to the inability to examine clinical records.…”

Section: Myocardial Infarction and Anginamentioning

confidence: 99%

Gout and Hyperuricemia—Serious Risk Factors for Morbidity and Mortality or Just Indicators of “The Good Life”—The Evidence to Date

Fernández

Markenson

2015

Curr Treat Options in Rheum

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Gout and hyperuricemia are associated with cardiovascular disease and its major risk factors and even more closely with chronic kidney disease. The preponderance of results from observational cohorts demonstrate that gout and hyperuricemia are associated with an increased risk of cardiovascular disease and chronic kidney disease that is independent of other factors, though that increase is of a smaller magnitude than that seen with traditional risk factors. In some studies, the relative increase in risk associated with elevated uric acid is more pronounced in women than in men. We have interpreted these results as a prompt to be more aggressive in screening our gout patients for modifiable cardiovascular risk factors and chronic kidney disease and reducing those risks as much as possible through lifestyle changes, modifications to diet, and medications. Many gout patients have indications for urate-lowering therapy related to their disease, so the dilemma of whether to initiate treatment is not present. There has not yet been sufficient demonstration in randomized controlled trials of benefit from urate-lowering therapies in patients with asymptomatic hyperuricemia with regard to cardiovascular or renal outcomes. However, there are intriguing preliminary results in several studies that may demonstrate a specific benefit of allopurinol or febuxostat in certain populations.

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Section: Myocardial Infarction and Anginamentioning

confidence: 99%

Gout and Hyperuricemia—Serious Risk Factors for Morbidity and Mortality or Just Indicators of “The Good Life”—The Evidence to Date

Fernández

Markenson

2015

Curr Treat Options in Rheum

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“…The risk of stroke seems to be increased as well in gouty patients. 19 Subclinical indicators of CV involvement, such as the carotid intima-media complex thickness and the presence of atherosclerotic plaques, also seem to be more prevalent in gouty patients than in control non-gouty patients. 20 All these data quite strongly suggest that in gouty patients CV complications of atherosclerosis are heightened, explaining the resulting higher mortality.…”

Section: When To Start Urate Lowering Therapy?mentioning

confidence: 99%

When to Start Urate Lowering Therapy?

2015

Egypt J of Rheumatol & Clinical Immunol

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“…Hyperuricemia is an independent risk factor for hypertension, which is one the most common comorbidities of gout (92,93). Hyperuricemia and gout were both found to be associated with increased risk of stroke and myocardial infarction and CV mortality (94)(95)(96). Use of thiazide and loop diuretics has been associated with an increased risk of gout (97).…”

Section: Comorbid Disease Managementmentioning

confidence: 99%

An Old Disease with New Insights: Update on Diagnosis and Treatment of Gout

Bıtık¹,

Ozturk²

2014

Eur J Rheumatol

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Gout is an acute and chronic inflammatory disorder associated with high morbidity and impaired quality of life. There has been a substantial increase in the prevalence and incidence of gout in recent years. Novel diagnostic and therapeutic options have provided new insights into the pathogenesis and management of hyperuricemia and gout in the last decade. This clinical review aims to summarize the diagnostic process and management of acute and chronic gout.

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Gout as a risk factor for myocardial infarction and stroke in England: evidence from record linkage studies

Abstract: Gout was associated with increased risk of stroke as well as MI. These findings should be considered by clinicians and may have implications for preventive management of circulatory disease risks in people with gout.

Cited by 89 publications

References 34 publications

Gout and Hyperuricemia—Serious Risk Factors for Morbidity and Mortality or Just Indicators of “The Good Life”—The Evidence to Date

Gout and Hyperuricemia—Serious Risk Factors for Morbidity and Mortality or Just Indicators of “The Good Life”—The Evidence to Date

When to Start Urate Lowering Therapy?

An Old Disease with New Insights: Update on Diagnosis and Treatment of Gout

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