pressure-lowering medications like calcium channel blockers and losartan may
protect against gout in people with hypertension, according to a recent study.
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.
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.
1. Antihypertensive drugs and risk of incident gout among patients with hypertension: population based case-control study; Hyon et al; BMJ 2012.