Stephen P. Juraschek, MD, PhD Assistant Professor, Harvard Medical School Beth Israel Deaconess Medical Center Division of General Medicine, Section for Research Boston, MA  02215

Which Blood Pressure Medications Are Better For Patients At Risk of Gout?

MedicalResearch.com Interview with:

Stephen P. Juraschek, MD, PhD Assistant Professor, Harvard Medical School Beth Israel Deaconess Medical Center Division of General Medicine, Section for Research Boston, MA  02215

Dr. Juraschek

Stephen P. Juraschek, MD, PhD
Assistant Professor, Harvard Medical School
Beth Israel Deaconess Medical Center
Division of General Medicine, Section for Research
Boston, MA  02215

MedicalResearch.com: What is the background for this study?

Response: Gout is a common complication of blood pressure treatment. Furthermore, 75% of adults with gout have hypertension. There are several classes of medications uses to treat hypertension. While prior studies have reported that calcium channel blockers like amlodipine lower uric acid, its effects on gout risk compared to other common first-line antihypertensive agents are unknown. 

MedicalResearch.com: What are the main findings?

Response: In this secondary analysis of a large, randomized trial (over 20,000 adults) we found that amlodipine lowered risk of gout greater than chlorthalidone or lisinopril. This suggests that for adults with hypertension and higher risk of gout, amlodipine may be a preferable choice to lower gout risk.

MedicalResearch.com: What should readers take away from your report?

Response: Our findings are directly applicable for patients with gout undergoing treatment to lower blood pressure as well as health practitioners prescribing medications for hypertension in adults with gout. In adults with hypertension where gout is a major concern, simply switching to a amlodipine, a common, first-line agent, could lower risk of gout.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

  • Additional work is needed to understand the impact of other interventions known to improve blood pressure (weight loss, healthy diet) on uric acid and gout
  • Mechanisms by which amlodipine lowers uric acid should be a focus of subsequent research as this observation has been seen in several other large trials (AASK, TOMHS)

Citation:

The effects of antihypertensive class on gout in older adults secondary analysis of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial

Juraschek, Stephen P.a; Simpson, Lara M.b; Davis, Barry R.b; Shmerling, Robert H.a; Beach, Jennifer L.a; Ishak, Anthonyc; Mukamal, Kenneth J.a

Journal of Hypertension: January 20, 2020 – Volume Publish Ahead of Print
doi: 10.1097/HJH.0000000000002359

https://journals.lww.com/jhypertension/Abstract/publishahead/The_effects_of_antihypertensive_class_on_gout_in.97048.aspx

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Last Modified: Jan 28, 2020 @ 12:31 pm

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