Hypertension and the risk of incident gout in a population-based study: the atherosclerosis risk in communities cohort

J Clin Hypertens (Greenwich). 2012 Oct;14(10):675-9. doi: 10.1111/j.1751-7176.2012.00674.x. Epub 2012 Jun 13.


The authors quantified the impact of hypertension on gout incidence in middle-aged white and African American men and women. The Atherosclerosis Risk in Communities Study (ARIC) was a prospective population-based cohort that recruited patients between 1987 and 1989 from 4 US communities. Using a time-dependent Cox proportional hazards model, the authors estimated the adjusted hazard ratio (HR) of incident gout by time-varying hypertension and tested for mediation by serum urate level. There were 10,872 participants among whom 45% had hypertension during follow-up; 43% were men and 21% were African American. Over 9 years, 274 (2.5%) participants developed gout (1.8% of women and 3.5% of men). The unadjusted HR of incident gout was approximately 3 times (HR, 2.87; 95% confidence interval [CI], 2.24-3.78) greater for those with hypertension. Adjusting for confounders resulted in an attenuated but still significant association between hypertension and gout (HR, 2.00; 95% CI, 1.54-2.61). Adjustment for serum urate level further attenuated but did not abrogate the association (HR, 1.36, 95% CI, 1.04-1.79). There was no evidence of effect modification by sex (P=.35), race (P=.99), or obesity at baseline (P=.82). Hypertension was independently associated with increased gout risk in middle-aged African American and white adults. Serum urate level may be a partial intermediate on the pathway between hypertension and gout.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • African Americans
  • Arteriosclerosis / epidemiology*
  • Arteriosclerosis / pathology
  • Cohort Studies
  • Community Networks
  • Confidence Intervals
  • Female
  • Gout / epidemiology*
  • Gout / pathology
  • Humans
  • Hypertension / complications
  • Hypertension / pathology*
  • Incidence
  • Male
  • Middle Aged
  • Prospective Studies
  • Qualitative Research
  • Risk Assessment
  • Statistics as Topic
  • Time Factors
  • United States / epidemiology
  • Whites