Category Archives: Risks

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.

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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.

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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.”

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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.
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Gout Misinformation Shaming

Gout Is No Joke: Misinformation & Shaming May Prevent People from Getting Appropriate Care


“Gout is so 18th century. It’s like, why don’t I get scarlet fever and syphilis as well, while I’m about it?”  – Columnist and restaurant critic Giles Coren, The Times, September 13, 2014

That’s just one of hundreds of gout jokes, cartoons and snide jabs that have been spied in the media in the last few years — and that doesn’t take into account a rich tradition of gout lampoonery dating back at least to the 18th century (Google “James Gillray”). Then or now, it’s hard to imagine another disease that gets so little respect. And that’s a problem, according to New Zealand researchers. They say the press perpetuates myths about gout that downplay its seriousness and prevent sufferers from getting treatment.
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Gout News Medication Risk

Severe Skin Reactions to Gout Drug Allopurinol Linked to Race

Americans of Asian and African descent have much higher risk than white and Hispanic Americans of developing rare but severe, sometimes life-threatening skin reactions to the gout drug allopurinol (Zyloprim), according to a new study published recently in Seminars in Arthritis & Rheumatism.

These two skin reactions, called Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), cause flu-like symptoms, a widespread rash, and large portions of the upper layer of skin (including mucus membranes) to blister and detach. They can also damage other major organs. SJS and TENS, which are believed to be different manifestations of the same disorder, are usually caused by a reaction to a drug (including acetaminophen [Tylenol] and certain antibiotics).
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Fructose Sugar Gout

Fructose and Gout: What’s the Link?

Most of us know how sugar affects our waistline. Too much of the sweet stuff contributes to obesity, and with it, diseases like diabetes and heart disease. Overdoing it on one type of sugar in particular—the high fructose corn syrup found in sodas and processed foods—can also set off painful gout. Considering that the average American eats 22 to 30 teaspoons of sugar daily, gout is yet another health risk worth noting.

Fructose is a natural sugar found in fruit and honey. High fructose corn syrup is a man-made sweetener produced from corn. It’s composed of 55 percent fructose and 45 percent glucose. Why is this type of sugar harder on your joints than other forms, like glucose? “Fructose is metabolized differently from glucose,” explains Peter Simkin, MD, emeritus professor of medicine in the University of Washington School of Medicine division of Rheumatology.

As the body breaks down fructose, chemical compounds called purines are released. The breakdown of purines produces uric acid—the substance that forms painful crystals in the joints and causes gout. Within minutes after you drink high fructose corn syrup-sweetened soda, your uric acid levels rise. Continue reading Fructose and Gout: What’s the Link?

Coffee Gout

Does Coffee Help or Hurt Gout?

Nearly two-thirds of Americans start their day with a cup or more of coffee. Besides its wake-up java jolt effect, coffee could be good for your health. Studies have linked regular coffee consumption with a lower risk for heart disease, some types of cancer, and type 2 diabetes, among other conditions.

Could your morning cup of Joe also help prevent bouts of painful gout? While some evidence suggests this popular beverage might help you avoid joint pain, the caffeine it contains might actually lead to more flare-ups if you already have gout.

Coffee and Gout Prevention

A 2007 study investigated the potential link between coffee intake and gout risk among nearly 46,000 men. The authors found that men who drank four to five cups of coffee a day had a 40 percent lower relative risk of gout compared to men who weren’t coffee drinkers. Decaf coffee also modestly lowered gout risk, but tea didn’t have any effect, suggesting that something other than caffeine is responsible for the effect on gout.
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Wine and Gout Flares

Wine Implicated in Gout Flares

Beer and hard liquor have long been known to increase the risk of gout, the most common form of inflammatory arthritis, but according to a 2014 study in The American Journal of Medicine, wine also can contribute to recurrent gout attacks.

Gout occurs when excess uric acid builds up around joints – often in the big toe, but also in the feet, ankles, knees, wrists and elbows – leading to episodes of intense pain, redness and swelling. It affects more than 8 million adults in the United States, and the numbers are rising sharply, due mainly to obesity and other lifestyle factors.

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