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Meta-Analysis
. 2021 Jul;41(7):1209-1219.
doi: 10.1007/s00296-021-04876-6. Epub 2021 May 13.

The incidence and prevalence of cardiovascular diseases in gout: a systematic review and meta-analysis

Peter Cox  1 , Sonal Gupta  2 , Sizheng Steven Zhao  3 , David M Hughes  4
Affiliations
Meta-Analysis

The incidence and prevalence of cardiovascular diseases in gout: a systematic review and meta-analysis

Peter Cox et al. Rheumatol Int. 2021 Jul.

Abstract

The aims of this systematic review and meta-analysis were to describe prevalence of cardiovascular disease in gout, compare these results with non-gout controls and consider whether there were differences according to geography. PubMed, Scopus and Web of Science were systematically searched for studies reporting prevalence of any cardiovascular disease in a gout population. Studies with non-representative sampling, where a cohort had been used in another study, small sample size (< 100) and where gout could not be distinguished from other rheumatic conditions were excluded, as were reviews, editorials and comments. Where possible meta-analysis was performed using random-effect models. Twenty-six studies comprising 949,773 gout patients were included in the review. Pooled prevalence estimates were calculated for five cardiovascular diseases: myocardial infarction (2.8%; 95% confidence interval (CI)s 1.6, 5.0), heart failure (8.7%; 95% CI 2.9, 23.8), venous thromboembolism (2.1%; 95% CI 1.2, 3.4), cerebrovascular accident (4.3%; 95% CI 1.8, 9.7) and hypertension (63.9%; 95% CI 24.5, 90.6). Sixteen studies reported comparisons with non-gout controls, illustrating an increased risk in the gout group across all cardiovascular diseases. There were no identifiable reliable patterns when analysing the results by country. Cardiovascular diseases are more prevalent in patients with gout and should prompt vigilance from clinicians to the need to assess and stratify cardiovascular risk. Future research is needed to investigate the link between gout, hyperuricaemia and increased cardiovascular risk and also to establish a more thorough picture of prevalence for less common cardiovascular diseases.

Keywords: Cardiovascular disease; Gout; Meta-analysis; Prevalence.

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Conflict of interest statement

The authors have no conflicts of interest or funding to declare.

Figures

Fig. 1
Fig. 1
Study selection flowchart
Fig. 2
Fig. 2
Forest plots of pooled prevalence of: a 2.8% for myocardial infarction, b 8.7% for heart failure, c 2.1% for venous thromboembolism, d 4.3% for cerebrovascular accident and e 63.9% for hypertension
See this image and copyright information in PMC

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