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Gout and cardiovascular disease

crystallized confusion

Abeles, Aryeh M.a; Pillinger, Michael H.b

Current Opinion in Rheumatology: March 2019 - Volume 31 - Issue 2 - p 118–124
doi: 10.1097/BOR.0000000000000585
EPIDEMIOLOGY AND HEALTH-RELATED SERVICES: Edited by Kenneth Saag

Purpose of review Gout is associated with the risk of cardiovascular morbidity and mortality, but the biological relationship between the two remains uncertain. The demonstration of reduction of cardiovascular risk with appropriate gout treatment would argue for a causal role for gout in cardiovascular disease. We reviewed recent studies that address the relationship between gout and cardiovascular disease.

Recent findings Studies are conflicting; some show that lowering serum uric acid levels leads to better cardiovascular outcomes, whereas others show no such benefit. Inconsistencies in study design may contribute to these variations in outcome. Additionally, different gout treatment strategies may affect cardiovascular outcomes differently.

Summary Despite an abundance of data generated in the last 5 years, it remains unclear whether treating gout with urate-lowering therapy provides a cardiovascular benefit. Additionally, further studies are needed to clarify whether different urate-lowering drugs confer different cardiovascular risks or benefits. Nonurate-lowering agents used for gout or commonly used in gout patients, such as colchicine and statins, may also improve cardiovascular outcomes in this population.

aDivision of Rheumatology, University of Connecticut Health Center, Meriden

bCrystal Diseases Study Group, Division of Rheumatology, New York University School of Medicine, New York, USA

Correspondence to Aryeh M. Abeles, MD, University of Connecticut Health Center, 816 Broad Street Suite 14, Meriden, CT 06450, USA. Tel: +1 203 235 6402; e-mail: aabeles@uchc.edu

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