Gout and Heart Disease: How Risk Factors for Gout May Impact Your Heart Health

gout and heart disease

Gout, a form of inflammatory arthritis, affects more than 8 million people in the US.1 Gout can eventually cause permanent damage to bones and joints of adults if left unmanaged.2 In addition, the risk factors for gout can impact the cardiovascular system.3 Read on to find out about the potential correlation between gout risk factors and heart disease and talk to your doctor about how it might impact you.

 

Know the risk factors

Heart disease is one of the leading causes of death worldwide3 and the number one cause of death in the US4. According to the Centers for Disease Control and Prevention, more than 600,000 people in the US die of heart disease each year, or one out of every four deaths.4 Heart disease is the leading cause of death for both men and women.4

Risk factors for heart disease include:

  • Metabolic syndrome (a combination of health problems that can include diabetes, abnormal or high blood cholesterol and obesity, among others)5
  • Diabetes or prediabetes6
  • High blood pressure (hypertension)6
  • Abnormal or high cholesterol (dyslipidemia)6
  • Being overweight or obese4
  • Being physically inactive4
  • Family history of early heart disease6
  • History of preeclampsia (a pregnancy complication; the main symptoms are high blood pressure, protein in the urine and swollen hands and feet)6
  • Smoking6
  • Excessive alcohol use4
  • Unhealthy diet6
  • Age (55 or older for women)6
  • Ethnicity (non-Hispanic whites, non-Hispanic blacks and American Indians)7

High blood pressure, high cholesterol and smoking are considered key risk factors for heart disease.4 Nearly half of Americans have at least one of these three risk factors.4

 

Understand the potential connection between a high uric acid level and heart disease

According to a 2015 editorial written for the Annals of the Rheumatic Diseases by Jasvinder A Singh, MD, PhD, Professor of Medicine in the Division of Clinical Immunology and Rheumatology at the UAB School of Medicine in Birmingham, Alabama, “considerable data show an increased risk of cardiac disease in patients with gout, above and beyond that contributed by the traditional risk factors for heart disease.”3

In his review of data from the Framingham Offspring Study (FOS) of nearly 5,000 American adults, Dr. Eswar Krishnan found that participants who had gout were two to three times more likely to suffer with clinical heart failure than those who did not have gout.8 Dr. Krishnan’s review also revealed that the risk of death was higher in heart failure patients who had gout than in heart failure patients who did not have gout.8

Data from many other studies and reviews add to the growing body of evidence that gout may impact the cardiovascular system.9,10 However, additional research is needed to further clarify the relationship between gout and heart disease.

 

Manage your gout

If you have gout, ask your doctor about treatment regimens for adults that may help prevent gout flares. You should also talk to your doctor about how to best manage the risk factors for heart disease that you can control. You may not be able change your family history, but you can make an effort to eat more healthfully, get more exercise and (if you smoke) quit smoking.

 

NOTE: This article was not written by a medical professional and is not intended to substitute for the guidance of a physician. These are not Hikma’s recommendations for gout flare prevention, but rather facts and data collected from various reliable medical sources. For a full list of resources and their attributing links, see below.

References

  1. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum. 2011;63(10):3136–3141.
  2. Gout. University of Washington Orthopaedics and Sports Medicine website. Available at: http://www.orthop.washington.edu/?q=patient-care/articles/arthritis/gout.html. Accessed June 1, 2018.
  3. Singh JA. When gout goes to the heart: does gout equal a cardiovascular disease risk factor? Ann Rheum Dis. 2015;74:631–634.
  4. Heart Disease/Heart Disease Facts. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/heartdisease/facts.htm. Accessed June 1, 2018.
  5. Galassi A, Reynolds K, He J. Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med. 2006; 119(10):812–819.
  6. Lower Heart Disease Risk/What Are the Risk Factors for Heart Disease? National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health/educational/hearttruth/lower-risk/risk-factors.htm. Accessed June 1, 2018.
  7. Heart Disease/Family History and Other Characteristics That Increase Risk for Heart Disease. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/heartdisease/family_history.htm. Accessed June 1, 2018.
  8. Krishnan E. Gout and the risk for incident heart failure and systolic dysfunction. BMJ Open. 2012;2:e000282.
  9. Singh JA, Cleveland JD. Gout and the risk of myocardial infarction in older adults: a study of Medicare recipients. Arthritis Res Ther. 2018;20:109. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984737/pdf/13075_2018_Article_1606.pdf. Accessed August 15, 2018.
  10. Gaffo AL, Edwards NL, Saag KG. Hyperuricemia and cardiovascular disease: how strong is the evidence for a causal link? Arthritis Res Ther. 2009;11:240. Available at: https://arthritis-research.biomedcentral.com/track/pdf/10.1186/ar2761. Accessed August 15, 2018.

Important Safety Information for Mitigare® (colchicine) 0.6 mg capsules

  • Colchicine 0.6 mg capsules are contraindicated in patients with renal or hepatic impairment who are currently prescribed drugs that inhibit both P-gp and CYP3A4. Combining these dual inhibitors with colchicine in patients with renal or hepatic impairment has resulted in life-threatening or fatal colchicine toxicity. Patients with both renal and hepatic impairment should not be given Mitigare®.
  • Fatal overdoses have been reported with colchicine in adults and children. Keep Mitigare® out of the reach of children.
  • Blood dyscrasias such as myelosuppression, leukopenia, granulocytopenia, thrombocytopenia, and aplastic anemia have been reported with colchicine used in therapeutic doses.
  • Monitor for toxicity and if present consider temporary interruption or discontinuation of colchicine.
  • Drug interaction with dual P-gp and CYP3A4 inhibitors: Co-administration of colchicine with dual P-gp and CYP3A4 inhibitors has resulted in life-threatening interactions and death.
  • Neuromuscular toxicity and rhabdomyolysis may occur with chronic treatment with colchicine in therapeutic doses, especially in combination with other drugs known to cause this effect. Patients with impaired renal function and elderly patients (including those with normal renal and hepatic function) are at increased risk. Consider temporary interruption or discontinuation of Mitigare®.
  • The most commonly reported adverse reactions with colchicine are gastrointestinal symptoms, including diarrhea, nausea, vomiting, and abdominal pain.

Indication

Mitigare® is indicated for prophylaxis of gout flares in adults. The safety and effectiveness of Mitigare for acute treatment of gout flares during prophylaxis has not been studied.

Mitigare® is not an analgesic medication and should not be used to treat pain from other causes.

For Full Prescribing Information please CLICK HERE and for Medication Guide CLICK HERE.

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Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

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Important Safety Information for Mitigare® (colchicine) 0.6 mg capsules

  • Colchicine 0.6 mg capsules are contraindicated in patients with renal or hepatic impairment who are currently prescribed drugs that inhibit both P-gp and CYP3A4. Combining these dual inhibitors with colchicine in patients with renal or hepatic impairment has resulted in life-threatening or fatal colchicine toxicity. Patients with both renal and hepatic impairment should not be given Mitigare®.
  • Fatal overdoses have been reported with colchicine in adults and children. Keep Mitigare® out of the reach of children.