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Gout Associated With Subsequent Cardiac Arrhythmia

Gout appears to be associated with the occurrence of subsequent cardiac arrhythmia, a new study suggests. In addition, hypertension appears to be the major risk factor that aggravates development of atherosclerosis in hyperuricaemic patients.

Concentrations of serum uric acid, the end-product of purine metabolism, are often elevated in patients with hypertension or ischaemic heart disease. However, the role of uric acid and gout in the development of cardiovascular diseases is unclear.

Juan-Chia Lin, MD, with the National Yang-Ming University, in Taipei, Taiwan, and colleagues conducted a 7-year follow-up study among 391 men with hyperuricaemia. Participants were all at least 30 years of age and screened from a community-based study that initially took place in 1991-92. Of the participants in that study, 75% were later assessed again in 1997-98.

Factors for coronary heart disease included age, increase of uric acid level, baseline systolic blood pressure, and increase of systolic blood pressure while factors associated with left ventricular hypertrophy included baseline systolic blood pressure and increase in systolic blood pressure, the researchers report.

They also found that gouty syndrome, age, baseline fasting plasma glucose level, and increase of systolic blood pressure were significantly related to cardiac arrhythmia.

In addition, after adjustment for baseline serum uric acid level, hyperuricaemic men with hypertension, especially overt hypertension stage 2 and stage 3, was related to cardiovascular disease incidence, and this association was synergistic with uric acid level.

While gout and elevated uric acid level seemed not to be an independent risk factor for most cardiovascular diseases, blood pressure level was predictive for cardiovascular disease incidence synergistically with serum uric acid level, Dr. Lin and colleagues conclude.

"Although hyperuricemia and hypertension are clearly linked, the mechanisms underlying this relation are uncertain," the authors note.

Hyperuricaemia may predispose patients to the development of hypertension, or it may influence the rate of blood pressure progression and/or its effects on other organs such as the kidney, heart brain, or vascular endothelium, they suggest.



J Rheumatol 2004;31:1152-1158. "Hypertension was the major risk factor leading to development of cardiovascular diseases among men with hyperuricemia"

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