Gout is a condition where uric acid levels in the
blood rise, either due to increased production of uric acid by the body or
decreased excretion in the urine. It causes joint inflammation, especially of
the big toe, resulting in a painful, swollen and red toe. Other joints like the
knee and ankle may also be affected. In addition, gout can result in uric acid
stones in the urinary tract and kidney damage.
There are some medications used for hypertension
i.e. high blood pressure and other conditions that can cause gout as a side
effect. Among
these are the thiazide diuretics. These drugs increase the absorption of uric
acid by the kidneys. Other diuretics like furosemide are also associated with
gout.
A
study was conducted to analyze the risk of gout with treatment using blood
pressure-lowering medications in hypertensive patients. Data was collected over
the period of 8 years and included a large number of people between the ages of
20 and 89 years.
The study
found that the risk for developing gout was less with calcium channel blockers
and losartan.
The risk was further reduced with increased duration of treatment and use of
higher doses of these medications. On the other hand, drugs belonging to
classes like diuretics, β blockers, angiotensin converting enzyme inhibitors,
and non-losartan angiotensin II receptor blockers were associated with a higher
risk for gout.
Calcium channel blockers like amlodipine and
nifedipine bring about increased excretion of uric acid in the urine. Losartan
also has a similar effect. This effect was however missing in other drugs
similar to losartan like candesartan, telmisartan, irbesartan and eprosartan.
A number of medications are available to treat hypertension.
Taking the results of this study into
account, it would probably be advisable to use drugs like calcium channel
blockers or losartan in patients already at a risk for gout.
Reference:
1. Antihypertensive drugs and risk of incident gout among patients with
hypertension: population based case-control study; Hyon et al; BMJ 2012.
Source-Medindia