Published online before print August 13, 2007, doi: 10.1161/CIRCULATIONAHA.107.703389
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(Circulation. 2007;116:894-900.)
© 2007 American Heart Association, Inc.
Coronary Heart Disease |
Independent Impact of Gout on Mortality and Risk for Coronary Heart Disease
From the Rheumatology Division (H.K.C.), Arthritis Research Centre of Canada, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, Canada; the Channing Laboratory (H.K.C., G.C.) and Renal Division (G.C.), Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass, and the Department of Epidemiology (G.C.), Harvard School of Public Health, Boston, Mass.
Correspondence to Dr Hyon K. Choi, Division of Rheumatology, Department of Medicine, University of British Columbia, Arthritis Research Centre of Canada, 895 West 10th Ave, Vancouver, BC V5Z 1L7, Canada.
Received March 15, 2007; accepted June 15, 2007.
Background— Although gout and hyperuricemia are related to several conditions that are associated with reduced survival, no prospective data are available on the independent impact of gout on mortality. Furthermore, although many studies have suggested that hyperuricemia is associated with cardiovascular disease (CVD), limited data are available on the impact of gout on CVD.
Methods and Results— Over a 12-year period, we prospectively examined the relation between a history of gout and the risk of death and myocardial infarction in 51 297 male participants of the Health Professionals Follow-Up Study. During the 12 years of follow-up, we documented 5825 deaths from all causes, which included 2132 deaths from CVD and 1576 deaths from coronary heart disease (CHD). Compared with men without history of gout and CHD at baseline, the multivariate relative risks among men with history of gout were 1.28 (95% confidence interval [CI], 1.15 to 1.41) for total mortality, 1.38 (95% CI, 1.15 to 1.66) for CVD deaths, and 1.55 (95% CI, 1.24 to 1.93) for fatal CHD. The corresponding relative risks among men with preexisting CHD were 1.25 (95% CI, 1.09 to 1.45), 1.26 (95% CI, 1.07 to 1.50), and 1.24 (95% CI, 1.04 to 1.49), respectively. In addition, men with gout had a higher risk of nonfatal myocardial infarction than men without gout (multivariate relative risk, 1.59; 95% CI, 1.04 to 2.41).
Conclusions— These prospective data indicate that men with gout have a higher risk of death from all causes. Among men without preexisting CHD, the increased mortality risk is primarily a result of an elevated risk of CVD death, particularly from CHD.
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