Gout: an independent risk factor for all-cause and cardiovascular mortality.
OBJECTIVE
The relation of gout and hyperuricaemia to cardiovascular diseases has been well documented. This study investigates the survival impact of both gout and hyperuricaemia.


METHODS
The subjects of this study comprised participants of a health screening programme conducted by the Chang Gung Memorial Hospital in Taiwan from 2000 to 2006. The status and causes of death were ascertained by the Taiwan National Death Registry 2000-07. Cox proportional hazard model was performed to examine the association.


RESULTS
Among 61 527 subjects, 1383 deaths (198 cardiovascular deaths) were identified, corresponding to a crude mortality rate of 4.86 deaths per 1000 person-years. Crude mortality rates were 4.50, 5.61 and 10.46 deaths per 1000 person-years for subjects with normouricaemia, hyperuricaemia and gout, respectively. Compared with subjects with normouricaemia, the hazard ratios (HRs) of all-cause mortality were 1.46 (95% CI 1.12, 1.91) for individuals with gout and 1.07 (95% CI 0.94, 1.22) for those with hyperuricaemia, respectively, after adjustments were made for age, sex, component number of metabolic syndrome and proteinuria. The adjusted HRs of cardiovascular mortality were 1.97 (95% CI 1.08, 3.59) for individuals with gout and 1.08 (95% CI 0.78, 1.51) for those with hyperuricaemia. Moreover, the risk of all-cause or cardiovascular mortality for gout remained unchanged when limiting the data to those with an estimated glomerular filtration of >60 ml/min/1.73 m(2).


CONCLUSIONS
This study demonstrates a link of gout, not hyperuricaemia, with a higher risk of death from all causes and cardiovascular diseases.
Kuo
Chang-Fu
CF
Graduate Institute of Clinical Medical Sciences, Chang Gung University, Kwei-Shan Tao-Yuan, Taiwan.
See
Lai-Chu
LC
Luo
Shue-Fen
SF
Ko
Yu-Shien
YS
Lin
Yu-Sheng
YS
Hwang
Jawl-Shan
JS
Lin
Chi-Ming
CM
Chen
Hung-Wei
HW
Yu
Kuang-Hui
KH
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D004812:Epidemiologic Methods; D005260:Female; D005919:Glomerular Filtration Rate; D006073:Gout / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D033461:Hyperuricemia / Q000150:complications / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D013624:Taiwan / Q000453:epidemiology