Study: Gout Flare Ups Can Lead to Four-Times Higher Risk of Heart Attack, Stroke

For patients with gout, a flare up could increase their risk of heart attack or stroke for 4 months after the event, according to research published by experts at the University of Nottingham in JAMA.

“This is the first study of its kind to examine whether there is an association between recent gout flares and heart attacks and strokes,” said Abhishek Abhishek, MBBS, MD, FRCP, PhD, lead author on the study and researcher at the University of Nottingham’s School of Medicine, in a press release.

Gout affects 1 in 40 adults in the United Kingdom, according to researchers. It is a common type of arthritis produced by high levels of uric acid, which is found in certain food and drinks and is also produced when tissues break down in the body.

When uric acid levels are high, the chemical will form deposits of needle-shaped urate crystals in and around the joints. Sometimes these crystals will be released from their deposit on the joint and will move through the body, causing severe inflammation that can lead to several weeks of redness, joint pain, swelling, and tenderness. This is also known as a gout flare and is usually a recurrent event.

Inflammation is a risk factor for cardiovascular events like heart attacks and strokes, and patients with gout face more risk factors due to their high levels of inflammation. However, there have been no known studies looking at the risk of heart attack or stroke and gout flares, according to the researchers.

Experts studied whether gout flares were linked to an increased risk of heart attack or stroke following the flare up. Researchers adjusted their findings based on patient comorbidities, socioeconomic deprivation, lifestyle factors, and prescribed medication.

The investigators collected anonymous data of 62,574 gout patients who were treated by the UK’s National Health Service. Most patients had similar age, sex, and duration of gout flares, but 10,475 had experienced a heart attack or stroke after their gout diagnosis.

Individuals who experienced a gout flare up were more likely to have a heart attack or stroke within the 60 days following the flare up, according to the study. In the 61 to 120 days after the flare, they were 1.5 times more likely to suffer from a heart attack or stroke.

Patients with gout who died from a heart attack or stroke were also 4 times more likely to have experienced a flare in the previous 60 days, with 2 times greater odds of having a flare in the 61 to 120 days before the cardiovascular event.

“These findings suggest that gout flares are associated with a transient increase in cardiovascular events following flares,” Abhishek said the a press release.

The researchers also examined the risk of a cardiovascular event in the 0 to 15 and 16 to 30 days following a flare up. Their research showed similar increased odds of experiencing heart failure or stroke.

“People with recurrent gout flares should be considered for long-term treatment with urate lowering treatments such as allopurinol. This is a reliable way of removing urate crystal deposits and providing freedom from gout flares,” Abhishek said in the press release. “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. 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 minimize their background risk of heart attack and stroke.”

Reference

Flare-ups of gout are linked to heart attack and stroke, says new study. EurekAlert! Aug 2, 2022. Accessed on Aug 3, 2022. https://www.eurekalert.org/news-releases/960344