BETH ISRAEL DEACONESS MEDICAL CENTER

Boston – Affecting more than 7 million adults in the United States, gout is characterized by a sudden onset of pain, swelling and stiffness in the joints and caused by the formation of urate crystal in small spaces between joints that builds up when high amounts of uric acid circulate in the blood. While gout is linked to consuming some foods, including red meat, seafood, and alcohol, it is also a common complication of blood pressure management and a frequently cited reason patients don’t take their medication as directed. However, few studies provide guidance for physicians selecting antihypertensive medications for patients at risk for gout.

A new study led by physician-researchers at Beth Israel Deaconess Medical Center (BIDMC) reports that the antihypertensive drug amlodipine lowered long-term gout risk compared to two other drugs commonly prescribed to lower blood pressure. The findings are published in the Journal of Hypertension.

“Our study is clinically relevant as the prevalence of gout has been rising in the United States and the number of Americans meeting newly-revised diagnostic thresholds for hypertension has doubled,” said corresponding author Stephen Juraschek, MD, PhD, Assistant Professor of Medicine at BIDMC. “Our study demonstrated that amlodipine was associated with a lower risk of gout compared with chlorthalidone or lisinopril, which has never been reported prior to this study.”

Juraschek and colleagues conducted a secondary analysis of the data generated by the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). This clinical trial evaluated the effect of common blood pressure drugs on cardiovascular outcomes in more than 20,000 participants treated at 623 medical centers in North America between 1994 and 2002.

“Further research is needed to confirm these findings,” said Juraschek. “Other health outcomes, such as heart failure, should also be considered with choosing a blood pressure drug.”

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In addition to Juraschek, authors included Robert H. Shmerling, MD, Jennifer L. Beach, MD, and Kenneth Mukamal, MD, MPH, MA, all of BIDMC; Kara M. Simpson, PhD, and Barry R. Davis, MD, PhD, of the Health Science Center at Houston at the University of Texas.

This work was supported by a grant from the National Institutes of Health/National Heart, Lung and Blood Institute (K23HL135273). The authors have no conflicts of interest to report.