Clinical Characteristics Of Primary Gout Complicated With Hypertension In Northeast Sichuan

Objective:To provide reference data for early prevention and intervention of primary gout complicated with hypertension by analyzing the clinical characteristics of patients with such disease in northeastern Sichuan and screening the risk factors of hypertension in gout patients.Methods:In this study,766 cases of primary gout diagnosed in the Affiliated Hospital of Northern Sichuan Medical College from October 2015to January 2018 were collected,including the information of name,gender,age,History,family history,medication history,gout history,smoking and drinking history.Height,weight,and blood pressure were measured to calculated the body mass index(BMI=weight/height 2).Blood was collected after 12 hours of fasting to measure ESR,hepatorenal function,blood lipids,and blood glucose.Cases divided into simple gout group(GNH)and gout with hypertension group(GAH),are compared retrospectively in the clinical characteristics and laboratory test data.Logistic regression model was used to analyze the risk factors of gout with hypertension.Results:(1)In this study,766 primary gout patients were included,and514 patients with gout(age44.12±13.70,male 507,female,7)and 252patients with gout and hypertension(age 55.73±13.23,male 240,female,12).Men are more likely to suffer from primary gout.The group GAH is older than the group GNH(t=4.308,p<0.01)and has a longer duration(t=11.147,p<0.01).(2)Inducements of the two groups were analyzed,including beer,including high-fat diet,seafood,fatigue,cold,others(mood,weather changes,high-sugar diet,etc).The results suggested that GNH had a higher proportion of inducement in fatigue than GAH,which difference was statistically significant(?~2=4.059,p<0.05).However,there was no statistical difference in smoking and drinking between the two groups(p>0.05).(3)Of the patients with gout,96.60%had only one joint involved in the first attack,while 46.08%had the first metatarsophalangeal joint involved first.18.02%of the patients were complicated with tophus.Nevertheless,GAH accounted for 52.90%.Tophograms of the two groups showed that GAH was more likely to incorporate tophi(?~2=47.419,p<0.01).(4)The systolic blood pressure,diastolic blood pressure and BMI index in gout with hypertension group were all higher than gout group(t=13.663,p<0.01;t=8.069,p<0.01;t=9.01,p<0.01).(5)In comparison of laboratory data between the two groups,GAH were higher in ESR,Cr,UA,TG(t=2.48,p<0.01;t=2.918,p<0.05;t=3.193,p<0.05;t=5.721,p<0.01),while lower in HBG,RBC,ALT,ALB than GNH(t=-3.781,p<0.01;t=-2.835,p<0.05;t=-4.394,p<0.01;t=-3.172,p<0.05).(6)The level of UA in GNH was positively correlated with ESR,WBC,PLT,ALT,AST,ALB,GLOB,TG,VLDL,Cr(r=0.115,p<0.05;r=0.094,p<0.05;r=0.139,p<0.05;r=0.208,p<0.01;r=0.21,p<0.01;r=0.152,p<0.05;r=0.178,p<0.01;r=0.198,p<0.01;r=0.099,p<0.05;r=0.247,p<0.01),and the level of UA in GAH was positively correlated with WBC ALT,AST,TG,Cr(r=0.136,p<0.05;r=0.127,p<0.05;r=0.126,p<0.05;r=0.293,p<0.05;r=0.206,p<0.05).(7)Logistic regression revealed that gout course,tophus,UA,and TG may be associated with GAH.Conclusion:(1)Patients with GAH should take measures in an early time:reducing uric acid,controlling blood pressure,treating tophi,correcting lipid metabolism,and delaying target organ damage.(2)Gout course,tophus,UA and TG are all independent risk factors for GAH patients.(3)In northeastern Sichuan,compared with GNH,patients with GAH have larger ages,longer gout duration,higher blood pressure and uric acid levels.Meanwhile,they are more likely to be associated with tophi,impaired lipid metabolism,and renal impairment.