Gout Linked to Higher Decade-Long Risk of Heart Attack and Stroke, New Study Finds
South Korea: A large population-based study from South Korea has found that people with gout remain at a significantly higher risk of major cardiovascular (CV) events over a decade, even when long-term changes in blood pressure and cholesterol are taken into account. Researchers reported that worsening of these risk factors over ten years further magnified the likelihood of stroke, heart attack, and death.
Gout is a chronic inflammatory condition characterized by elevated uric acid levels and recurrent attacks of painful arthritis. While its connection to cardiovascular disease has been suspected for years, the study offers one of the most comprehensive assessments of how the disease interacts with evolving risk factors over time.
The investigation, published in Rheumatology and led by Dr. Byeongzu Ghang of the Division of Rheumatology at Jeju National University School of Medicine and Jeju National University Hospital, analyzed data from the Korean National Health Insurance claims database and the National Health Screening Program. It included 113,853 adults newly diagnosed with gout after January 2012 and more than 1.1 million age- and sex-matched individuals without gout. All participants were followed for ten years to track changes in cardiovascular risk factors and the occurrence of major adverse events.
The study led to the following notable findings:
- Gout independently predicted serious cardiovascular complications, even after accounting for baseline risk factors and their changes over a decade.
- Patients with gout had a 50% higher risk of cerebral hemorrhage compared with controls.
- The risk of cerebral infarction (ischemic stroke) was 36% higher in the gout group.
- Myocardial infarction risk was elevated by 39% among those with gout.
- All-cause mortality was modestly but significantly higher, with a 7% increase.
- Worsening diastolic blood pressure over ten years was linked to greater odds of both myocardial infarction and cerebral infarction.
- Rising total cholesterol levels during the same period were associated with an increased risk of cerebral hemorrhage.
These findings highlight the importance of monitoring long-term trends, not just single-point measurements, when managing cardiovascular health in gout patients.
The authors stress that effective control of traditional cardiovascular risks—such as blood pressure and cholesterol—remains crucial in people with gout, but it may not be enough on its own. “Gout itself appears to confer an additional burden of cardiovascular risk that persists even after accounting for baseline health and decade-long changes,” they noted.
Clinicians are encouraged to adopt a proactive approach, combining uric acid management with aggressive monitoring of blood pressure and lipid levels throughout the disease course. The research underscores that cardiovascular prevention in gout should be dynamic, with periodic reassessment of risk factors to prevent major events such as stroke and heart attack.
"The study strengthens the call for integrated care strategies, reminding both patients and healthcare providers that gout is not merely a joint disease but a systemic condition with serious implications for long-term cardiovascular health," the authors concluded.
Reference:
Ghang, B., Kim, J., Kang, T., & Kim, H. J. Ten-year cardiovascular risk changes and major adverse events in gout patients. Rheumatology. https://doi.org/10.1093/rheumatology/keaf322
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