The risk of heart attacks and strokes temporarily increases during the four months following a gout flare-up, according to UK researchers.
They found that gout patients who experienced a heart attack or stroke were twice as likely to have had a flare-up in the 60 days prior to the event.
“People with gout should be encouraged to adopt a healthy lifestyle”
Abhishek Abhishek
In addition, they were one and a half times more likely to have experienced a gout flare-up in the 61-120 days prior, said the researchers the University of Nottingham and Keele University.
Their study into the common form of arthritis that affects one in 40 UK adults is published in the Journal of the American Medical Association.
The study authors noted that gout symptoms were caused by high levels of uric acid that were deposited in and around joints as needle shaped urate crystals.
These crystals caused severe inflammation manifesting as joint pain, swelling, redness, and tenderness – commonly known as gout flares – that lasted one to two weeks.
In addition, the researchers highlighted that inflammation was also a risk factor for heart attack and stroke and that people with gout tended to have more cardiovascular risk factors.
However, they noted that there have been no previous studies about whether gout flares are linked with an increased risk of heart attack and stroke.
As a result, they set out to investigate whether there was a temporary increase in risk of heart attack or stroke after a gout flare.
The researchers looked at data from 62,574 NHS patients who had been treated for gout. Of these, 10,475 experienced heart attack or stroke after the diagnosis of gout.
They found gout patients who suffered a heart attack or stroke were twice as likely to have had a gout flare in the previous 60 days, and one and a half times more likely in the preceding 61-120 days.
Gout patients who died from a heart attack or stroke had over four times the odds of experiencing a gout flare in the preceding 0-60 days and over twice the odds of a flare in the preceding 61-120 days.
Writing in the journal, the study authors said: “Among individuals with gout, those who experienced a cardiovascular event, compared with those who did not experience such an event, had significantly higher odds of a recent gout flare in the preceding days.
“These findings suggest gout flares are associated with a transient increase in cardiovascular events following the flare.”
Professor Abhishek Abhishek, lead author on the study, added: “This is the first study of its kind to examine whether there is an association between recent gout flares and heart attacks and strokes.”
He noted that patients with recurrent gout flares should be considered for long-term treatment with urate lowering treatments, such as allopurinol, which was a “reliable way of removing urate crystal deposits and providing freedom from gout flares”.
“Patients should also be considered for concurrent treatment with anti-inflammatory medicines such as colchicine for the first few months, because urate lowering treatments may trigger gout flares in the short term,” he said.
He also said: “People with gout should be encouraged to adopt a healthy lifestyle with appropriate treatment of conditions such as high blood pressure, high cholesterol, obesity and diabetes to minimise their background risk of heart attack and stroke.”
