Blood Pressure Drug Linked To Lower Risk Of Gout
by Beth Israel Deaconess Medical Center
Affecting more than 7 million adults in the United States, gout is characterized by a sudden onset of pain, swelling and stiffness in the joints and caused by the formation of urate crystal in small spaces between joints that builds up when high amounts of uric acid circulate in the blood. While gout is linked to consuming some foods, including red meat, seafood, and alcohol, it is also a common complication of blood pressure management and a frequently cited reason patients don’t take their medication as directed. However, few studies provide guidance for physicians selecting antihypertensive medications for patients at risk for gout.
A new study led by physician-researchers at Beth Israel Deaconess Medical Center reports that the antihypertensive drug amlodipine lowered long-term gout risk compared to two other drugs commonly prescribed to lower blood pressure. The findings are published in the Journal of 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,” said corresponding author Stephen Juraschek, MD, Ph.D., Assistant Professor of Medicine at BIDMC. “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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Strengths And Weaknesses Of This Study
Our study had a large number of confirmed cases of incident gout, and we prospectively collected and validated the dietary intake data. Potential biased recall of diet was avoided in this study because the intake data were collected before the diagnosis of gout. As dietary consumption was self reported by questionnaire, some misclassification of the exposure is inevitable. However, dietary consumption that was self reported has been extensively validated in subsamples of this cohort, and any remaining misclassification would have likely biased the results toward the null. The use of repeated dietary assessments in the analysis not only accounts for changes in dietary consumption over time, but also decreases measurement error. The validity of gout ascertainment in these cohorts has been documented by the high degree of concordance with medical record review.
Kidneys Vital To Prevent Hypertension And Gout
The kidneys primary function is to remove waste substances from your blood. Over time, unchecked high blood pressure from a poor diet and lifestyle can cause arteries around the kidneys to weaken, narrow, and harden.
These damaged arteries prevent sufficient blood and oxygen to reach the kidneys. As a result, the weakened kidneys produce less aldosterone, a hormone that regulates blood pressure. Without proper treatment, the kidneys can begin to lose their ability to filter excess salt, water, fat, uric acid and other wastes.
In due time, these excess waste products build up in the body. For example excess fat in the blood forms cellulite in and around the body. Similarly, excess uric acid accumulates in joint causing gout and tophus.
Weakened kidneys by poor diet sets up the body to be prone to hypertension and gout. Optimal kidney function is vital in removing unhealthy food byproducts including uric acid.
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Achieve A Healthy Weight
Research indicates that being overweight is a modifiable risk factor associated with the onset of gout. Eating more food increases the risk of having too much uric acid in your blood.
Findings from a study of 14,000 American adults found that individuals who were classified as being overweight based on body mass index had an 85% higher risk of having elevated uric acid levels compared to those who had an average BMI. Researchers reported that carrying extra weight alone was linked to 44% of the hyperuricemia cases identified in the study group.
The Atherosclerosis Hypertension Gout Connection
Atherosclerosis is the buildup of plaque on and in artery walls. The result is poor circulation of blood and insufficient oxygen supply to parts of the body. Atherosclerosis is a major factor of hypertension, which makes your body more prone to gout.
Plaque comes from food byproducts such as cholesterol, fat, calcium and blood clotting agents. A high level of LDL cholesterol is an indicator of plaque build-up.
As seen in the above video, blood pressure increases because of blocked or hardened arteries, and thicker blood. There are a variety of food sources or substances that cause plaque buildup and atherosclerosis.
Iron Overload Increases Frequency of Gout
Iron aids in red blood cell production and blood clotting. The condition when there is an overload of iron in the body is called hemochromatosis. Consequently, hypertension is developed due to the blood becoming thicker and harder to pump.
Since the body cannot remove excess iron, the absorbed iron deposits accumulate in joints, liver, testicles, and heart. Over time, this can cause health conditions like arthritis, fatigue, diabetes, sexual dysfunction, heart disorders and cirrhosis of the liver.
Also, a 2018 New Zealand study confirmed high levels of ferritin and iron in the body increased uric acid levels and gout flare frequency. Keep in mind, ferritin is the main protein in which iron is stored.
Alcohol Triggers Fat and Uric Acid Production
Salt Raises Blood Pressure but Lowers Uric Acid
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Hypertension Causes Major Complications
Regularly monitoring your blood pressure is quite important and yet overlooked. Hypertension does not usually show obvious or early symptoms. That is why it known as the silent killer. Your blood pressure can quickly rise and remain high without you knowing it until a major health issue happens.
Over time, unmanaged high blood pressure can cause serious complications: heart attack/failure, stroke, aneurysm, chronic kidney disease, eye damage, and clogged arteries.
Hypertension sets up disorders of lesser degree such as fatigue, dizziness, blurred vision, irregular heartbeat, difficulty breathing and gout symptoms.
The link between gout and hyperuricemia are often overlooked even when 74% of chronic gout sufferers have high blood pressure. If you have hypertension, make sure to ask your doctor to test for your uric acid levels as well.
If you appreciate computer generated videos like I do, then youll like this one. Here is a fantastic video illustrating high blood pressure, atherosclerosis or plaque build up.
Gout And High Blood Pressure: What You Need To Know
Gout and high blood pressure can be a particularly dangerous combination. This is due to gout already causing the bodys tissues and joints to swell, and this may cause gout attacks which gout victims find hard to put up with. The joint pain associated with gout means that people suffering from gout may end up bed-ridden for several days, and gout pain can also last for several months.
High blood pressure is the medical term used to describe an increase in blood pressure above normal levels. Elevated blood pressure puts extra strain on the heart, which has to work harder than normal to pump the increased volume of blood around the body. As gout sufferers are more likely to suffer from gout attacks and gout pain, their quality of life can be severely affected. Furthermore, gout patients who also have high blood pressure are more likely to fall ill with gout-related problems such as gouty arthritis.
In this blog post, you will learn several things about gout and hypertension for elderly people.
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Blood Pressure Diet May Also Help For Gout
A diet that helps people reduce high blood pressure may also offer a non-drug treatment for gout a type of inflammatory arthritis, a new study suggests.
Lowers uric acid
The clinical trial included more than 400 people who ate the so-called DASH diet , or a typical American diet.
Along with lowering blood pressure, the DASH diet also significantly lowers levels of uric acid. Uric acid crystals are known to cause gout, the Arthritis Foundation says.
Read:Myths about gout are hampering its treatment
The DASH diet’s effect for some people with gout was so strong that it nearly matched the effectiveness of drugs normally used to treat the painful condition, the study authors said.
The findings suggest that dietary changes could offer an effective and safe way to lower uric acid levels. That would possibly prevent gout flare-ups for people with mild to moderate gout who can’t or don’t want to take gout drugs, the researchers explained.
“Results of this trial are good news to patients with high blood levels of uric acid or those at risk for gout. A dietary approach to prevent gout should be considered first-line therapy,” said study senior author Dr Edgar Miller III.
Read:Krystexxa Approved for Gout
He is a professor of medicine at Johns Hopkins University School of Medicine in Baltimore.
The study was published in the journal Arthritis and Rheumatology.
Read more:
Reduce Purines In Your Diet
You may be increasing your risk of gout attacks if your diet includes foods high in purines. Avoiding these foods, which are high in purines, may help prevent symptoms.
- Organ and glandular meats, including kidney and liver
- Game meats like venison
- Some types of seafood such as scallops, shellfish, sardines, and tuna
- Foods and beverages high in sugar, especially those sweetened with high fructose corn syrup
While reducing foods high in purines can be beneficial to managing gout, increasing your consumption of the following foods and beverages may also help limit gout symptoms:
- Coffee
- Fruits and vegetables rich in vitamin C
- Low-fat dairy products
Modifying your diet with these recommendations can lower uric acid levels and reduce the amount of purines your body has to process.
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Effect On Uric Acid Levels Nearly Matches Impact Of Gout Medicines
- Date:
- Johns Hopkins Medicine
- Summary:
- A diet rich in fruits, vegetables, low-fat dairy and reduced in fats and saturated fats , designed decades ago to reduce high blood pressure, also appears to significantly lower uric acid, the causative agent of gout. Further, the effect was so strong in some participants that it was nearly comparable to that achieved with drugs specifically prescribed to treat gout, a new study shows.
A diet rich in fruits, vegetables, low-fat dairy and reduced in fats and saturated fats , designed decades ago to reduce high blood pressure, also appears to significantly lower uric acid, the causative agent of gout. Further, the effect was so strong in some participants that it was nearly comparable to that achieved with drugs specifically prescribed to treat gout, a new study led by Johns Hopkins researchers shows.
The findings — derived from a randomized clinical trial — could offer an effective, safe and sustainable dietary approach to lower uric acid and possibly prevent gout flare-ups in those with mild to moderate disease and who can’t or don’t want to take gout drugs.
In the original DASH-sodium trial, 412 participants ate either the DASH diet or a typical American diet for three months. For each month of the study, the participants’ diets provided a different level of sodium in a random order, including low , medium , and a high level . The high sodium level was comparable to the average daily intake in a typical American diet.
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Cherries And Foods With Vitamin C
Some foods like cherries and fruits and vegetables high in vitamin C have been shown to lower the level of uric acid in your blood, which can have a positive effect on gout. Some examples of foods high in vitamin C are:
- Oranges
- Bell peppers
- Pineapples
There is mixed evidence about whether cherries, and foods with high vitamin C can help prevent gout. Eating these foods will not treat gout the way that medicines can. In some cases, they may help improve your condition in some way.
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Some Meat Fish Eggs Beans And Pulses
Eat these foods in moderation. Having vitamin C with meals can help to improve the absorption of iron, so drink a small glass of orange juice, have a piece of fruit for dessert, or serve up meals with plenty of vegetables. Keep your portions of meat controlled by using your hands as a serving size guide. A serving is about the size and thickness of the palm of your hand.
What Is Already Known On This Topic
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The Dietary Approaches to Stop Hypertension diet reduces blood pressure and is also recommended to prevent cardiovascular disease
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A recent analysis of a DASH randomized trial found that the DASH diet also lowers levels of serum uric acid among patients with hyperuricemia however, corresponding data for the risk of gout are not available
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In contrast, the Western diet contains many individual foods that have previously been established to increase levels of serum uric acid and the risk of gout
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Can You Get Rid Of Gout
It ought to be fairly obvious why youd want to get rid of gout, but is it possible actually?
Sure can be, but theres not just a one-size suits all solution.
In the next section, well come to be going over whats worked greatest for us!
You wont want to lose out on this free video.
NOTICE: Id highly recommend going to your doctor or seeing a specialist about this situation, since we arent experts. See our medical disclaimer for more details.
We dont know what will work for you, but we know whats worked for us and others
Treating A Gout Attack
As is true for many painful conditions, the first-line treatment for a gout attack is taking one of the nonsteroidal anti-inflammatory drugs , such as diclofenac, ibuprofen, or indomethacin. For people who can’t take NSAIDs, a drug called colchicine is an alternative. It’s been used for centuries maybe even longer specifically for gout. The trouble with colchicine is its side effects, especially the copious diarrhea. If neither an NSAID nor colchicine is an option, then gout attacks can be treated with an oral corticosteroid, such as prednisone, or with corticosteroid injections into the joints.
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High Blood Pressure Is Hypertension
If you have gout, then youve been to the doctor enough to know what blood pressure is and how its measured. If you dont, click this link for the explanation from The American Heart Association.
According to the American Society of Hypertension guidelines, blood pressure categories are:
- Normal: lower than 120/80
- Pre-hypertension: 120/80 to 139/89
- Hypertension: above 140/90
For clarification, many people misconstrue muscle or mental stress, as hypertension. They are not the same. Stress can cause a temporary spike in blood pressure, via blood vessels constricting, but it will eventually return to a normal. The unhealthy reactions to stress like smoking, drinking alcohol and overeating is what raises blood pressure.
Hypertension is synonymous with high blood pressure . Stress can raise blood pressure temporarily. Unhealthy habits when reacting to stress will cause high blood pressure.
For more details on sneaky gout triggers, read: The Absolute Worst Foods For Chronic Gout Sufferers
Gout And High Blood Pressure Medication
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Using Tart Cherry Juice For Gout
Tart cherry juice may help decrease uric acid levels and inflammation in gout. Research is limited, with often small numbers of study participants and short-term follow-up.
Nevertheless, a 2019 review of six studies that looked at the effect of cherry juice or cherry extract intake on gout concluded that cherry intake was associated with a reduced risk of gout attacks. Researchers did note that larger, more long-term studies are needed to clarify this association.
When choosing tart cherry juice, be sure to look for unsweetened varieties to help reduce the amount of added sugar in your diet.
Risk According To Body Mass Index Alcohol Use And Hypertension Status
We conducted stratified analyses to evaluate whether the association between the DASH and Western dietary pattern scores and the risk of gout varied according to body mass index, alcohol use, and hypertension status. Table 3 shows that relative risks from these stratified analyses consistently suggested associations similar to those from the main analysis, and there was no significant interaction with these variables .
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