Blood Pressure Control Declined in Patients With Gout Between 2007 and 2018

Between 2007 and 2018, fewer patients with gout achieved blood pressure control, while glucose and lipid control remained stable despite increased use of glucose-lowering medication, according to a study published in Rheumatology.

Researchers sought to investigate trends in risk factor control and medication use based on data from the National Health and Nutrition Examination Study (NHANES). They analyzed NHANES data, including blood pressure, hemoglobin A_1C levels, serum cholesterol levels, and patient-reported medication use from data collection periods between 2007 to 2008 and 2007 to 2018. Sample data was weighted to produce estimates representative of the noninstitutionalized civilian US population. Logistic regression analyses were performed to assess temporal trends in risk factor control and medication usage. Participant characteristics affecting risk factor control was also assessed.

The prevalence of participants who achieved blood pressure control decreased from 64.6% during the 2007 to 2008 data collection period to 55.3% during the 2017 to 2018 data collection period (P =.03). Control of lipids and glucose remained consistent between 2007 and 2018 (P >.05). Patient characteristics significantly associated with risk factor control included age (45-65 and ³65 years), Asian American and non-Hispanic Black ethnicities, and body mass index greater than 25.0 kg/m².

The use of glucose-lowering medications increased from 71.0% during the 2007 to 2008 data collection period to 94.7% during the 2017 to 2018 data collection period (P <.01). No significant changes were observed in the prevalence of blood pressure-lowering and lipid-lowering medications.

Limitations of the study included the small sample size, which limited the ability to detect small changes in the measured variables over time, nonresponse bias due to declining NHANES response rates, recall bias of self-reported medication use, and the possibility of insufficient time to observe trends, especially in glycemic and lipid control.

The study authors concluded, “Based on NHANES data, a significant trend towards decreased blood pressure control was observed in patients with gout, while glycemic and lipid control leveled off. These findings emphasize that more endeavors are needed to improve management of cardiovascular risk factors in patients with gout.”

Reference

Li L, Tian J, Wang R, et al. Trends in risk factor control in patients with gout: data from the National Health and Nutrition Examination Survey, 2007-2018. Rheumatology (Oxford). Published online April 26, 2022. doi:10.1093/rheumatology/keac254