Which antihypertensive drugs are associated with gout and hyperuricemia related adverse effects?

Researchers have found in a new study that antihypertensive drugs like potassium-sparing diuretics, calcium channel blockers and losartan are associated with increase in the risk of adverse events related to hyperuricemia and gout. Further antihypertensive drugs with central action, alpha and beta blockers, renin inhibitors, and vasodilators may also be associated with an increased risk of hyperuricemia, gout, or related adverse events.

The findings were published in Frontiers in Pharmacology.

The use of antihypertensive drugs has long been a topic of concern in regards to inducing hyperuricemia and gout, yet clinical studies in this area have been limited and have produced inconsistent results. So, Xue-Feng Jiao and colleagues aimed to evaluate the association between different antihypertensive drugs and the occurrence of hyperuricemia, gout, and related adverse events using the FDA Adverse Event Reporting System (FAERS). 

The findings of this review were:

46 antihypertensive drugs had positive signals for hyperuricemia, 66 for gout, 27 for gouty arthritis, 8 for gouty tophus, and 6 for urate nephropathy. These drugs included diuretics, antihypertensive drugs with central action, alpha blockers, beta blockers, alpha and beta blockers, calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, renin inhibitors, vasodilators, and compound preparations. Additionally, 42 antihypertensive drugs had positive signals for more than one adverse event.

Some potassium-sparing diuretics, calcium channel blockers, and losartan may be associated with an increased risk of hyperuricemia, gout, or related adverse events, which is not consistent with previous studies.

The results also suggest that some antihypertensive drugs with central action, alpha and beta blockers, renin inhibitors, and vasodilators may also be associated with an increased risk of hyperuricemia, gout, or related adverse events, which has not been reported in previous studies. 

Overall, this study provides valuable information for healthcare professionals in considering the potential risks of hyperuricemia, gout, and related adverse events when selecting antihypertensive drugs for their patients. It highlights the need for further research in this area to better understand the relationship between antihypertensive drugs and these outcomes.

Source:

Jiao, X.-F., Song, K., Jiao, X., Li, H., Zeng, L., Zou, K., Zhang, W., Wang, H., & Zhang, L. (2023). Hyperuricaemia, gout and related adverse events associated with antihypertensive drugs: A real-world analysis using the FDA adverse event reporting system. In Frontiers in Pharmacology (Vol. 13). Frontiers Media SA. https://doi.org/10.3389/fphar.2022.1045561