gout and atrial fibrillation

The Link Between Gout and Atrial Fibrillation

What does a disease that inflames your joints have to do with an erratic heart rhythm? Quite a lot, it turns out. Researchers have discovered that people with gout are at increased risk for atrial fibrillation (AFib).

One recent study analyzed a sample of Medicare claims data from more than 1.6 million people ages 65 and older. Those with gout were up to 90 percent more likely to be diagnosed with AFib than those without gout. The risk was particularly high among elderly adults.

The potential link between the two conditions underscores the need for gout patients to pay attention to their heart health.

What’s Behind the Link?

The most obvious connection between gout and AFib is inflammation. Body-wide inflammation is a hallmark of both diseases. The two conditions also share a number of risk factors, including obesity, high blood pressure, and diabetes.

Uric acid is another factor AFib and gout have in common. Gout occurs when high uric acid levels in the blood cause hard crystals to form around joints. Uric acid is a marker for cardiovascular risk and inflammation, and increased levels have been independently linked to AFib.

Still, it’s been difficult for researchers to prove the exact cause of the gout-AFib connection. “Could inflammation be the underlying link? Sure. Could uric acid be the driver of that inflammation? Sure. Could other factors be involved? Sure,” says Jasvinder Singh, MD, MPH, the University of Alabama professor of medicine and epidemiology who co-authored the Medicare claims study. “We need to investigate all of these pathways to understand this better.”

Getting a Diagnosis

If you have gout, you need to think about your heart health. Having AFib can increase your risk for serious conditions like blood clots, heart failure, and stroke.

“I think the practical implication is that rheumatologists and primary care doctors should keep a heightened suspicion for arrhythmias [abnormal heart rhythms] in people with gout,” Dr. Singh says. Vigilance is particularly important for people who have other AFib risk factors, such as high blood pressure or coronary artery disease.

Your primary care doctor or cardiologist can diagnose AFib with an electrocardiogram (EKG), Holter monitor, and other tests. If you have the condition, treatments include medicines and devices to control your heart rate and rhythm, and drugs to prevent blood clots from forming.

Treating Gout to Protect Your Heart

The same medications that treat gout might do double duty by lowering your AFib risk. In a 2016 study Dr. Singh also co-authored, older adults who took allopurinol had a 17 percent lower risk of AFib. Among those who took the drug for more than 2 years, the risk dropped by 35 percent. Colchicine is also being investigated for lowering AFib risk.

The trouble is, less than half of people with gout stick to their treatment regimen, putting both their joints and heart at risk. “These studies are increasingly making the case that if patients have gout, they should get treatment for it. Treatment might also protect them from the cardiac condition,” Dr. Singh says.

Related Resources:

spinal gout arthritis pain

Could Your Back Pain Be Gout?

If you have ever had back pain, you know how difficult it can be to pinpoint the cause. From bone spurs to overworked muscles to slipped discs, there’s no shortage of ailments that could be at the root of your aching lumbar.

And here’s one more. Over the last 10 years, rheumatologists have documented more cases of gout appearing in the spine. So if you are one of the 8 million Americans with this inflammatory form of arthritis – and you have unexplained back or neck pain, tingling sensations down your arm or leg, or numbness – there’s a small chance the culprit could be your gout.

Continue reading Could Your Back Pain Be Gout?

foods to eat and avoid for gout management

What to Eat and Avoid for Gout

Food choices plays an important role in managing gout, the most common form of inflammatory arthritis in the United States. Gout occurs when uric acid builds up in the blood (instead of being excreted) and gets deposited as crystals in one or more joints, triggering sudden swelling and pain. Uric acid is a by-product of the breakdown of purines, naturally occurring compounds in the body and in certain foods, which is why diet can be important for controlling gout attacks.

We asked rheumatologist Hyon K. Choi, MD, a gout expert and Professor of Medicine at Harvard Medical School, what people with gout should know about diet.

Continue reading What to Eat and Avoid for Gout

Gout and OA—What’s the Connection?

A swollen, stiff knee might immediately lead you to suspect you have osteoarthritis (OA), but the culprit could also be gout. Like many close relatives, the two conditions share common features. And because they often occur together, you might wonder which one is causing your symptoms.

“It’s definitely possible for people to have both conditions at the same time. They’re the two most common types of arthritis,” says Svetlana Krasnokutsky, MD, assistant professor of medicine in the Division of Rheumatology at NYU Langone Health. “They can affect the same joints.”

Continue reading Gout and OA—What’s the Connection?

eat less meat - gout diet

Making Smart Meat Choices If You Have Gout

If you’re changing your diet to help lower uric acid levels and reduce your risk of gout attacks, meat choices can have a big impact. Some meats are high in purines.  Purines are substances found naturally in the body as well as in in foods. They are broken down in the body to form uric acid. When excess uric acid in the bloodstream builds too quickly or can’t be eliminated fast enough, it is deposited as needle-shaped crystals in the tissues of the body, including joints, causing intense pain.  So, a high-purine diet puts you at greater risk for uric acid buildup.  And a 2012 study in the Annals of the Rheumatic Diseases showed that the risk worsens as more purines are included in the diet. But what if meats are your favorite food? Here’s what you should know about your options.

Continue reading Making Smart Meat Choices If You Have Gout

dash diet for gout

Heart Diet Good for Gout

A diet that’s best known for promoting heart health may also help gout management. The Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fresh fruits and vegetables, whole grains and low-fat dairy products, may lower serum uric acid (SUA) levels. In a study published in Clinical Rheumatology in March 2017,  research findings showed that the diet reduced SUA [compared to the typical American (control) diet] within 30 days, with a sustained effect at 90 days. In an earlier study reported in Arthritis & Rheumatology in August 2016, researchers reported similar finding in some cases.

Continue reading Heart Diet Good for Gout

Gout News Medication Risk

Increasing Allopurinol Dose May Better Control Gout

In addition to being treated with medication for symptoms of an acute flare, should a person with gout be put on long-term uric acid-lowering medication to reduce future flares? And is it safe to keep raising the dose of the medication until uric acid drops below a specified target? Rheumatologists and other physicians are currently grappling with those questions, and a new study may help lead to some answers.

What Is Gout?

Gout is the most common form of inflammatory arthritis in the United States, affecting more than 8 million adults. It develops in some people who have high levels of uric acid in the blood. Needle-shaped crystals form in and around joints – often beginning in the base of the big toe – causing episodes of severe pain, heat and swelling.
Continue reading Increasing Allopurinol Dose May Better Control Gout

Gout and Premature Death Risk

People with Gout at Risk of Premature Death

A new study found that people with gout have a 25 percent greater likelihood of dying prematurely than people without gout. The findings also show that this increased mortality rate has not improved over the past 16 years, unlike the mortality rate for people with rheumatoid arthritis (RA).

Gout, which affects more than 4 percent of adults in the United States, is the most common form of inflammatory arthritis. It develops in some people who have high levels of uric acid in the blood. The acid can form needle-like crystals in a joint and cause sudden, severe episodes of pain, tenderness, redness, warmth and swelling. Gout is also associated with other illnesses, such as cardiovascular disease and metabolic syndrome.
Continue reading People with Gout at Risk of Premature Death

Gout Treat to Target

Panel Recommends Aggressive Treat-to-Target Approach to Gout

An international panel of leading gout experts has published new recommendations advising that doctors use a treat-to-target approach for managing gout, a painful form of arthritis that affects more than 8 million adults in the United States. Central to the recommendations is using medication to reduce and keep blood uric acid levels below 6 milligrams per deciliter (mg/dL) – and even lower in people with severe gout. The recommendations were published online in Annals of the Rheumatic Diseases in September.
Continue reading Panel Recommends Aggressive Treat-to-Target Approach to Gout