Amlodipine has lower gout risk compared to other antihypertensives: Study

Gout is a common complication of blood pressure management and a frequently cited cause of medication nonadherence. Some blood pressure-lowering drugs are also implicated with regard to gout risk.

Researchers have found that the antihypertensive medication amlodipine is associated with a lower risk for gout compared to other antihypertensive agents The study has been published in the Journal of Hypertension.

Dr Stephen P. Juraschekfrom Harvard Medical School in Boston and colleagues examined the relationship between antihypertensives and gout using data from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial, a randomized clinical trial that measured the effects of amlodipine, chlorthalidone, and lisinopril on fatal coronary heart disease and nonfatal myocardial infarction. The authors linked trial data for 23,964 participants to gout claims from the Centers for Medicare & Medicaid Services and Veterans Affairs.

The researchers found that compared with chlorthalidone and lisinopril, amlodipine was associated with a 37 and 26% lower risk for gout, respectively (hazard ratios, 0.63 [95% CI, 0.51 to 0.78] and 0.74 [95% CI, 0.58 to 0.94]), respectively). Compared with chlorthalidone, lisinopril also was associated with lower gout risk, although this difference was not significant (hazard ratio, 0.85; 95% confidence interval, 0.70 to 1.03). Treatment with atenolol was not associated with gout risk (hazard ratio, 1.18; 95% CI, 0.78 to 1.80). The reduction in gout risk was mostly observed after one year of follow-up.

The researchers concluded that Amlodipine lowered long-term gout risk compared with lisinopril or chlorthalidone. The finding may be useful in cases where gout risk is a principal concern among patients being treated for hypertension.

"Our study is clinically relevant as the prevalence of gout has been rising in the United States and the number of Americans meeting newly-revised diagnostic thresholds for hypertension has doubled," Juraschek said in a statement. "Our study demonstrated that amlodipine was associated with a lower risk of gout compared with chlorthalidone or lisinopril, which has never been reported prior to this study."

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DOI: 10.1097/HJH.0000000000002359