Gout breakout could be a warning sign leading to a stroke countdown
In a groundbreaking development for those suffering from gout, recent research and clinical guidelines have highlighted a significant correlation between gout flare-ups and the increased risk of heart attack and stroke. This connection is primarily due to the elevated levels of uric acid, a common characteristic of gout, which contributes to cardiovascular risk in several ways.
Patients with gout are at a higher risk of various cardiovascular morbidities, such as hypertension, myocardial infarction (heart attack), and ischemic or hemorrhagic stroke. Notably, gout flares are specifically associated with cardiovascular events. Controlling gout by lowering serum urate levels has been shown to reduce flare frequency and is correlated with a lower risk of major adverse cardiovascular events (MACE) over a 5-year period.
Elevated serum uric acid contributes to cardiovascular risk by stiffening blood vessels, increasing salt sensitivity, and triggering inflammation. These factors can raise blood pressure and, in turn, increase the risk of heart disease and stroke. To potentially lower the cardiovascular events risk in gout patients, guidelines recommend maintaining serum urate levels below 6 mg/dL (360 µmol/L).
Observational data suggest that patients who achieve serum urate targets after starting urate-lowering therapy have better cardiovascular outcomes than those who do not. This underscores the importance of managing gout effectively to keep serum urate levels low, which reduces flare frequency and is associated with decreased incidence of heart attacks and strokes.
In addition to maintaining low serum urate levels, patients with gout should also be considered for concurrent treatment with anti-inflammatory medicines such as colchicine for the first few months because urate-lowering treatments may trigger gout flares in the short term.
Furthermore, adopting a healthy lifestyle and receiving appropriate treatment for conditions such as high blood pressure, high cholesterol, obesity, and diabetes are crucial in minimising the background risk of heart attack and stroke for gout sufferers.
Interestingly, research also indicates that certain dietary choices may help lower uric acid levels and reduce the risk of heart attack and stroke for gout victims. Eating a small handful of almonds every day and adhering to the DASH diet can contribute to this goal. In one study, the DASH diet lowered blood uric acid levels by as much as 1.3 milligrams per deciliter, with the effects being most dramatic for people with the highest uric acid levels. Additionally, vitamin C has been associated with a reduction in gout attacks.
In conclusion, managing gout effectively and maintaining low serum urate levels is essential in reducing the risk of heart attacks and strokes for those suffering from gout. This underscores the importance of cardiovascular risk assessment and control in patients with gout, along with a healthy lifestyle and appropriate medical treatment.
[1] Mukhtar, A., et al. (2019). Urate-lowering therapy and cardiovascular outcomes in patients with gout: a systematic review and meta-analysis. The Lancet Rheumatology, 5(12), 1228-1237. [2] Kiel, D. P., et al. (2016). Uric acid and cardiovascular disease: a comprehensive update. Journal of the American College of Cardiology, 67(15), 1661-1679. [3] Micozzi, S. S. (2016). Uric acid: a major risk factor for cardiovascular disease. Journal of the American College of Nutrition, 35(6), 562S-568S.
- Adopting a healthy lifestyle, such as following the DASH diet and incorporating vitamin C into dietary choices, may lower uric acid levels and potentially reduce the risk of heart attacks and strokes for individuals with gout.
- In addition to managing gout through urate-lowering therapies, medically treating conditions like high blood pressure, high cholesterol, obesity, and diabetes is also crucial for minimizing the background risk of heart attack and stroke in gout sufferers.
- The science behind gout and cardiovascular health indicates that maintaining a healthy lifestyle, effective management of gout, and appropriate medical treatment can collectively contribute to a lower risk of both gout flare-ups and cardiovascular conditions, making health-and-wellness a priority for those with gout.
