Independent impact of gout on mortality and risk for coronary heart disease

Area of Science:

• Cardiovascular Epidemiology
• Rheumatology
• Public Health

Background:

• Gout and hyperuricemia are linked to conditions associated with reduced survival.
• Limited prospective data exist on gout's independent impact on mortality and cardiovascular disease (CVD).

Purpose of the Study:

• To prospectively examine the association between a history of gout and the risk of death and myocardial infarction in male participants.
• To determine if gout independently impacts mortality and CVD risk.

Main Methods:

• A 12-year prospective study of 51,297 male participants in the Health Professionals Follow-Up Study.
• Analysis of mortality (all causes, CVD, coronary heart disease [CHD]) and nonfatal myocardial infarction.
• Multivariate relative risks were calculated, adjusting for baseline characteristics and pre-existing CHD.

Main Results:

• Men with a history of gout had a 28% higher risk of total mortality (RR, 1.28).
• Gout was associated with a 38% increased risk of CVD deaths (RR, 1.38) and a 55% increased risk of fatal CHD (RR, 1.55).
• Men with gout also had a higher risk of nonfatal myocardial infarction (RR, 1.59).

Conclusions:

• Gout is independently associated with an increased risk of all-cause mortality in men.
• For men without pre-existing coronary heart disease (CHD), the elevated mortality risk is primarily driven by cardiovascular disease (CVD) deaths, especially from CHD.