Gout is Not Just Painful, It’s a Warning

The recent meeting of EULAR – the European League Against Rheumatism 2007 – brought a report of an analysis of some MRFIT results. A 16-year follow-up of over 9,000 men between 41 and 63 at entry, who had no evidence of coronary heart disease (CHD), provided information on the role of gout – or a raised uric acid level – in the risk of developing CHD.

To be classified as having gout, the subjects had to have a blood uric acid of 7 mg/dL or higher. After adjusting for possibly interfering factors, such as high blood pressure, high cholesterol, smoking, obesity, alcohol use, a family history of heart attack, use of diuretics or aspirin, and poor kidney function, men with gout were about 50% more likely to die from an acute heart attack (MI) than those without gout.

This means that physicians should aggressively screen men with gout – as they screen men with erectile dysfunction or diabetics – for cardiovascular risk factors.