Open AccessHypertension and the Risk of Incident Gout in a Population‐Based Study: The Atherosclerosis Risk in Communities Cohort
Author(s) -
McAdamsDeMarco Mara A.,
Maynard Janet W.,
Baer Alan N.,
Coresh Josef
Publication year - 2012
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1751-7176.2012.00674.x
Subject(s) - medicine , gout , hazard ratio , proportional hazards model , confounding , prospective cohort study , incidence (geometry) , population , cohort study , confidence interval , cohort , demography , environmental health , physics , optics , sociology
J Clin Hypertens (Greenwich). 2012; 14:675–679. ©2012 Wiley Periodicals, Inc. 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.