TY - JOUR
T1 - Hypertension and the Risk of Incident Gout in a Population-Based Study
T2 - The Atherosclerosis Risk in Communities Cohort
AU - Mcadams-Demarco, Mara A.
AU - Maynard, Janet W.
AU - Baer, Alan N.
AU - Coresh, Josef
PY - 2012/10
Y1 - 2012/10
N2 - 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 9years, 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.
AB - 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 9years, 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.
UR - http://www.scopus.com/inward/record.url?scp=84867103223&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84867103223&partnerID=8YFLogxK
U2 - 10.1111/j.1751-7176.2012.00674.x
DO - 10.1111/j.1751-7176.2012.00674.x
M3 - Article
C2 - 23031144
AN - SCOPUS:84867103223
SN - 1524-6175
VL - 14
SP - 675
EP - 679
JO - Journal of Clinical Hypertension
JF - Journal of Clinical Hypertension
IS - 10
ER -