Gout sufferers are 15 per cent more likely to die if they have a heart attack or stroke, a study has concluded.
Researchers fear the inflammatory condition – which strikes around 200,000 in the UK and eight million in the US, takes a burden on the heart.
Cardiologists at North Carolina’s Duke University analysed data from more than 17,000 heart disease patients to make the conclusion.
The form of arthritis, caused by a build-up of uric acid, a waste product of the body, famously afflicted Henry VIII and was rife in the Victorian era.
Did you know? Many patients don’t even realise a link exists between gout and heart problems
Several trials over the past few decades have uncovered a worrying link between gout and heart disease, with all pointing the finger at inflammation.
The new study, which was led by Dr Neha Pagidipata and followed heart disease patients for six years on average, offers more evidence to prove the link.
Slightly more than 1,400 participants had been diagnosed with gout at the beginning of the study, published in The Journal of the American Heart Association.
The researchers found that ‘in spite of aggressive medical therapy’, gout was linked to worse outcomes and death among heart disease patients.
Patients who had gout at any point during the study had a twofold increased risk of heart failure death compared to people who never developed gout.
WHAT IS GOUT?
Gout is the result of a build-up of uric acid in the blood and affects 200,000 people, most of them men, in the UK.
How is it diagnosed?
Detecting gout before the symptoms become apparent is difficult.
Men whose father and grandfathers suffer from gout are more prone to getting it. Once symptoms do appear, a test can find out how much uric acid is in the blood. Recent research has also identified a group of genes which could indicate whether young men are likely to develop the problem later in life.
What are the symptoms?
Gout tends to mainly affect the knees, ankles and big toe joints. It often appears as an acute attack, usually coming on overnight. Within 24 hours there is severe pain and swelling in the affected joint, and the skin may be red and shiny.
Even a bedsheet brushing against it can be agonising. Without treatment the attack subsides in a week or so.
When patients first develop gout there may be intervals of months, or even years, between attacks. As time goes by, these tend to become more frequent and more severe, and eventually other joints may be involved.
Once the gout reaches this stage, a state of chronic or continuous joint disease may develop, with progressive joint damage. The sufferer may even become permanently crippled.
Dr Pagidipata accepted that previous research has showed people with gout have a greater risk of heart disease – the world’s leading killer.
But she added that ‘a lot of those studies were done decades ago’ before preventative treatments such as statins became extremely common.
She said: ‘We wanted to take a more contemporary look at the relationship between gout and future heart disease in patients with known coronary artery disease.’
Dr Pagidipata warned many patients don’t even realise a link exists between gout and heart problems – despite the plethora of evidence.
Although it’s unclear why gout may boost the risk of heart disease, she said possible reasons include increased oxidative stress and inflammation.
Dr Pagidipata added: ‘We know that people who have a high level of inflammation are at an increased risk for cardiovascular disease.
‘And we also know gout is characterized by periods of acute inflammation. The link may have to do with that.
Dr Jasvinder Singh, who was not involved in the study, said the new research may help the public understand how insidious gout can be.
Dr Singh, a gout researcher at the University of Alabama, Birmingham, said: ‘Gout is not just a disease of the joints.
‘It’s a disease that causes inflammation in the joints and in the body. It’s not just a pain in the toe, it affects other organs, too, including the heart.
‘Patients may say, “I have an attack every two years, so shouldn’t I wait (for treatment) until it becomes more frequent?”
‘But in light of studies such as this one, patients might want to take that into account and know that leaving gout untreated might be affecting their cardiovascular health.’