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Comparative Study
. 2012 Jan 12:344:d8190.
doi: 10.1136/bmj.d8190.

Antihypertensive drugs and risk of incident gout among patients with hypertension: population based case-control study

Hyon K Choi  1 , Lucia Cea Soriano, Yuqing Zhang, Luis A García Rodríguez
Affiliations
Comparative Study

Antihypertensive drugs and risk of incident gout among patients with hypertension: population based case-control study

Hyon K Choi et al. BMJ. .

Abstract

Objective: To determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension.

Design: Nested case-control study.

Setting: UK general practice database, 2000-7.

Participants: All incident cases of gout (n = 24,768) among adults aged 20-79 and a random sample of 50,000 matched controls.

Main outcome measure: Relative risk of incident gout associated with use of antihypertensive drugs.

Results: After adjusting for age, sex, body mass index, visits to the general practitioner, alcohol intake, and pertinent drugs and comorbidities, the multivariate relative risks of incident gout associated with current use of antihypertensive drugs among those with hypertension (n = 29,138) were 0.87 (95% confidence interval 0.82 to 0.93) for calcium channel blockers, 0.81 (0.70 to 0.94) for losartan, 2.36 (2.21 to 2.52) for diuretics, 1.48 (1.40 to 1.57) for β blockers, 1.24 (1.17 to 1.32) for angiotensin converting enzyme inhibitors, and 1.29 (1.16 to 1.43) for non-losartan angiotensin II receptor blockers. Similar results were obtained among those without hypertension. The multivariate relative risks for the duration of use of calcium channel blockers among those with hypertension were 1.02 for less than one year, 0.88 for 1-1.9 years, and 0.75 for two or more years and for use of losartan they were 0.98, 0.87, and 0.71, respectively (both P<0.05 for trend).

Conclusions: Compatible with their urate lowering properties, calcium channel blockers and losartan are associated with a lower risk of incident gout among people with hypertension. By contrast, diuretics, β blockers, angiotensin converting enzyme inhibitors, and non-losartan angiotensin II receptor blockers are associated with an increased risk of gout.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare that HKC has received research funding for other projects from Takeda Pharmaceuticals and has served on advisory boards for Takeda Pharmaceuticals, Savient Pharmaceuticals, and URL Pharma; the authors have no relationship with companies that might have an interest in the submitted work in the previous three years; they have no non-financial interests that may be relevant to the submitted work.

Comment in

References

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