Investigation of the causal effects of hypertension, candesartan, lisinopril, and ramipril on gout

Abstract

Hypertension frequently coexists with gout, and previous studies have suggested a potential association between these conditions. Angiotensin converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are essential treatments for hypertension, though their effects on gout risk remains unclear and contradictory. We employed data from the FDA Adverse Event Reporting System (FAERS) alongside two-sample and multivariable Mendelian randomization (MR) analysis to evaluate the independent effects of hypertension, candesartan, lisinopril, and ramipril on gout risk. Analysis of FAERS data revealed that the lower bound of the 95% CI for ROR exceeded 1 for candesartan, lisinopril, and ramipril, suggesting potential associations with gout. However, two-sample MR analysis indicated significant causal links only for ramipril and hypertension. And in multivariable MR analysis, the association remained significant solely for hypertension. In summary, our study identifies a significant causal relationship between hypertension and gout risk but does not support a causal effect for the three antihypertensive medications-candesartan cilexetil, lisinopril, and ramipril.

Keywords: Adverse drug events; Angiotensin II receptor blockers; Angiotensin converting enzyme inhibitors; Gout; Hypertension; Mendelian randomization.