The impact of lifestyle on cardiovascular risk in patients with gout: a population-based cohort study
Seung Min Jung1, Sang-Hyuk Jung2, Su-Nam Lee3
1Division of Rheumatology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Insights
Patients with gout face high cardiovascular disease risk. A favorable lifestyle significantly lowers this risk, even with normal uric acid levels, highlighting the importance of lifestyle changes for gout patients.
Area of Science:
- Cardiology
- Rheumatology
- Preventive Medicine
Background:
- Gout significantly increases cardiovascular disease (CVD) risk.
- Understanding modifiable risk factors in gout patients is crucial for prevention.
Purpose of the Study:
- To assess the impact of a favorable lifestyle on incident CVD events in individuals with gout.
- To compare cardiovascular risk between gout and non-gout populations based on lifestyle and serum uric acid levels.
Main Methods:
- Utilized UK Biobank data to identify 9,110 gout patients and controls.
- Categorized lifestyle into favorable, intermediate, and unfavorable patterns based on smoking, physical activity, obesity, and diet.
- Estimated cardiovascular risk using serum uric acid levels and lifestyle patterns.
Main Results:
- Gout patients had a higher CVD incidence rate (11.38 vs 5.49 per 1000 person-years) than controls.
- Gout patients showed high CVD risk regardless of uric acid levels.
- A favorable lifestyle reduced CVD risk in both gout and non-gout populations, including those with gout.
Conclusions:
- Gout patients are at elevated CVD risk, even with normal uric acid.
- Lifestyle modifications offer an effective, cost-efficient strategy for CVD prevention in gout patients.
Aims:
Gout is associated with a significant burden of cardiovascular disease. The aim of this study was to evaluate the impact of a favourable lifestyle on incident cardiovascular events in patients with gout.
Methods:
We identified 9 110 patients with gout from the UK Biobank cohort based on self-report and/or hospital diagnostic codes. Lifestyle behaviours, including smoking status, physical activity, obesity, and diet, were categorized into three patterns: favourable (three to four healthy factors), intermediate (two healthy factors), and unfavourable (zero to one healthy factor). The cardiovascular risk of participants with and without gout was estimated based on their serum uric acid levels and lifestyle patterns.
Results:
Among 9 110 patients with gout and 457 596 participants without gout, the median follow-up duration was 8.9 years. The incidence rate of cardiovascular disease was significantly higher in the gout population than in the non-gout population (11.38 vs. 5.49 per 1000 person-years). The gout population consistently exhibited a high cardiovascular risk, irrespective of uric acid levels, whereas a positive correlation was observed between uric acid levels and cardiovascular risk in the non-gout population. Adopting a favourable lifestyle pattern was associated with a lower risk of cardiovascular disease in both gout and non-gout populations. Across all categories of uric acid, a favourable lifestyle was found to reduce cardiovascular risk in patients with gout.
Conclusion:
Patients with gout remain at high risk of developing cardiovascular disease despite having normal uric acid levels. Lifestyle modifications may represent an effective and cost-efficient therapeutic approach for preventing cardiovascular events in this population.
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