Uric acid

Researchers from Boston University School of Medicine (BUSM) have found that the incidence of gout and hyperuricemia (high uric acid levels) in the U.S. has risen significantly over the last 20 years and is associated with major medical disorders like hypertension and chronic kidney disease. The study, which is published in the American Journal of Medicine, was led by Hyon Choi, MD, DrPH, professor of medicine in the section of rheumatology and the clinical epidemiology unit at BUSM and rheumatologist at Boston Medical Center (BMC).

Gout is a common inflammatory arthritis triggered by crystallization of uric acid within the joints, causing severe pain and swelling.

Using data from the latest U.S. National Health and Nutrition Examination Survey (NHANES) conducted in 2007 and 2008, which included data from 5,707 participants, the researchers found that gout now affects 8.3 million Americans, or four percent of the population. They also found that hyperuricemia affects 43.3 million U.S. adults, or 21 percent of the population.

The study results demonstrated that participants with gout have remarkably high rates of hypertension (74 percent) and chronic kidney disease (71 percent). More than half of this patient population was obese (53 percent) and a significant number had diabetes (26 percent) and kidney stones (24 percent). These participants also showed high rates of heart attack (14 percent), heart failure (11 percent) and stroke (10 percent).

Additionally, study results showed that among individuals with the highest uric acid levels, rates of kidney disease (86 percent), hypertension (66 percent) and obesity (65 percent) were high. Approximately one third of the survey participants had heart failure and diabetes, and the prevalence of heart attack (23 percent) and stroke (12 percent) also were high.

"These findings highlight the remarkable prevalences and population estimates of medical disorders associated with gout and hyperuricemia in the U.S.," said Choi, the study's senior author. "Appropriate preventive and management measures of these associated conditions should be implemented in gout management, and when considering treatment strategies in gout, the lifestyle and pharmacologic measures that can concurrently improve serum uric acid and reduce associated disorders should be preferred."

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Boston University Medical Center: http://www.bmc.org