Gout Increases Incident Stroke Risk by the Same Magnitude as Diabetes

Gout may be a cerebrovascular risk factor for stroke similar to diabetes, but unlike diabetes, it is not a cardiovascular risk factor for myocardial infarction (MI). However, patients with both gout and diabetes are at a much higher risk for stroke and MI than with diabetes alone, according to a retrospective study published in Arthritis Research & Therapy.¹

Researchers analyzed US claims data from 2007 to 2010 for patients with diabetes (n=232,592), gout (n=71,755), both diabetes and gout (n=23,261), and neither disease (n=1,010,893). They found that gout was associated with a similar risk for incident stroke as diabetes (P =.5723), but a lower risk for incident MI compared with diabetes (P <.0001).

Patients with both gout and diabetes had a 1.4 times higher risk for incident stroke and MI for each compared with diabetes alone (P <.0001), indicating that the presence of gout significantly increases the risk for these events in individuals with both diseases.

It is important to note that there were several limitations of the study, including the unavailability of smoking status and lipid levels, as well as data on other potential risk factors for stroke and MI.

Previous studies have demonstrated an association between higher overall mortality in patients with gout,^2-4 but this is the first large, observational study to demonstrate that gout has an equivalent cerebrovascular risk to diabetes for stroke.

The authors concluded that, “On the basis of our study results, the presence of gout should alert physicians to screen, diagnose, and promptly treat cardiovascular risk factors (hypertension, hyperlipidemia), similar to the approach used in patients with diabetes.”

References

1. Singh JA, Ramachandaran R, Yu S, et al. Is gout a risk equivalent to diabetes for stroke and myocardial infarction? A retrospective claims database study. Arthritis Res Therapy. 2017;19:228.
2. Choi HK, Curhan G. Independent impact of gout on mortality and risk for coronary heart disease. Circulation. 2007;116(8):894-900.
3. Cohen SD, Kimmel PL, Neff R, Agodoa L, Abbott KC. Association of incident gout and mortality in dialysis patients. J Am Soc Nephrol. 2008;19(11):2204-2210.
4. Kuo CF, See LC, Luo SF, et al. Gout: an independent risk factor for all-cause and cardiovascular mortality. Rheumatology. 2010;49(1):141-146.