| Gout, the most common crystal-induced arthritis, is characterized by recurrent attacks. Gout and hyperuricemia, which leads to gout, have been linked to adverse cardiovascular events, but the biological mechanism is not clear. An understanding of gout's relation to cardiovascular outcomes and triggers for recurrent attacks are becoming an issue of greater public health importance given the rising prevalence of the disease. The following hypotheses were evaluated: (1) The quantity (including light-tomoderate amounts) and type of alcoholic beverage intake are associated with increased risk of recurrent gout attacks; (2) Weather-related factors are associated with increased risk of recurrent gout attacks; and (3) Hyperuricemia is associated with increased prevalence of carotid plaques but not coronary artery calcification, two markers of cardiovascular disease reflecting different pathologic features.;To address the first two hypotheses, 349 participants from an internet-based case-crossover study of individuals with gout were studied. In the first study, 1 to 2 servings of alcohol in the prior 24 hours, compared with no alcohol intake, were associated with a 40% (95% CI 0.88-2.33) increased risk of gout attack. All types of alcoholic beverages were associated with an increased risk of recurrent attacks.;In the second study, hot weather (≥80°F) and high humidity in the prior 24 hours, compared with moderate temperatures and normal humidity, respectively, were associated with increased risk for gout attacks (relative risk 1.64 (95% CI 1.02-2.64) and 1.30 (95% CI 1.06-1.60), respectively).;The third hypothesis was addressed using data from the National Heart, Blood, and Lung Institute (NHLBI) Family Heart Study. The adjusted risk of having prevalent carotid plaques was 1.75 times higher among males with SUA ≥6.8mg/dL than in those with the lowest levels of SUA (95% CI 1.21-2.51). For coronary artery calcification, the adjusted risk that was 1.06 times higher among males with the highest levels of SUA compared with the lowest levels (95% CI 0.70-1.59).;These studies provide insight into specific factors that trigger recurrent gout attacks, which may aid in making clinical recommendations to persons with gout, and into potential biological mechanisms through which uric acid may increase the risk of adverse cardiovascular disease. |
