title: Racial differences in the incidence of gout. The role of hypertension.
abstract: OBJECTIVE
  To estimate the incidence of and examine risk factors for the development of gout in black and white male physicians.
  
  
  METHODS
  Data from 2 cohorts of former medical students, 352 black men in the Meharry Cohort Study and 571 white men in the Johns Hopkins Precursors Study, were analyzed. Cases of gout were identified by self-report. Baseline variables and incident hypertension were examined as risk factors for the development of gout in both cohorts.
  
  
  RESULTS
  The incidence of gout was 3.11 and 1.82 per 1,000 person-years in the black men and the white men, respectively (P < 0.05); the cumulative incidence was 10.9% and 5.8%, respectively (P = 0.04). The relative risk (RR) for gout among the black men was 1.69 (95% confidence interval [95% CI] 1.02-2.80). This excess risk persisted after adjustment for baseline systolic blood pressure (adjusted RR = 1.96 [95% CI 1.14-3.38]). Incident hypertension was independently associated with the development of gout in univariate analysis (RR = 3.78 [95% CI 2.18-6.58]); when this variable was included as a time-dependent covariate in a Cox model, the excess risk for gout in black men was reduced and no longer significant (adjusted RR = 1.30 [95% CI 0.77-2.19]).
  
  
  CONCLUSIONS
  The approximately 2-fold excess risk for gout among black men is explained, in part, by a greater risk of incident hypertension.
authors.affiliation: University of Maryland School of Medicine, Baltimore, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Hochberg
authors.forename: J
authors.initials: J
authors.lastname: Thomas
authors.forename: D J
authors.initials: DJ
authors.lastname: Thomas
authors.forename: L
authors.initials: L
authors.lastname: Mead
authors.forename: D M
authors.initials: DM
authors.lastname: Levine
authors.forename: M J
authors.initials: MJ
authors.lastname: Klag
mesh_terms: D000328:Adult; D044383:Black People; D015331:Cohort Studies; D005500:Follow-Up Studies; D006073:Gout / Q000453:epidemiology / Q000208:ethnology* / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D044465:White People