title: Antihypertensive drugs and risk of incident gout among patients with hypertension: population based case-control study.
abstract: OBJECTIVE
  To determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension.
  
  
  METHODS
  Nested case-control study.
  
  
  METHODS
  UK general practice database, 2000-7.
  
  
  METHODS
  All incident cases of gout (n = 24,768) among adults aged 20-79 and a random sample of 50,000 matched controls.
  
  
  METHODS
  Relative risk of incident gout associated with use of antihypertensive drugs.
  
  
  RESULTS
  After adjusting for age, sex, body mass index, visits to the general practitioner, alcohol intake, and pertinent drugs and comorbidities, the multivariate relative risks of incident gout associated with current use of antihypertensive drugs among those with hypertension (n = 29,138) were 0.87 (95% confidence interval 0.82 to 0.93) for calcium channel blockers, 0.81 (0.70 to 0.94) for losartan, 2.36 (2.21 to 2.52) for diuretics, 1.48 (1.40 to 1.57) for β blockers, 1.24 (1.17 to 1.32) for angiotensin converting enzyme inhibitors, and 1.29 (1.16 to 1.43) for non-losartan angiotensin II receptor blockers. Similar results were obtained among those without hypertension. The multivariate relative risks for the duration of use of calcium channel blockers among those with hypertension were 1.02 for less than one year, 0.88 for 1-1.9 years, and 0.75 for two or more years and for use of losartan they were 0.98, 0.87, and 0.71, respectively (both P<0.05 for trend).
  
  
  CONCLUSIONS
  Compatible with their urate lowering properties, calcium channel blockers and losartan are associated with a lower risk of incident gout among people with hypertension. By contrast, diuretics, β blockers, angiotensin converting enzyme inhibitors, and non-losartan angiotensin II receptor blockers are associated with an increased risk of gout.
authors.affiliation: Section of Rheumatology and the Clinical Epidemiology Unit, Boston University School of Medicine, 650 Albany Street, Boston, MA 02118, USA. hchoius@bu.edu
authors.forename: Hyon K
authors.initials: HK
authors.lastname: Choi
authors.forename: Lucia Cea
authors.initials: LC
authors.lastname: Soriano
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Zhang
authors.forename: Luis A García
authors.initials: LA
authors.lastname: Rodríguez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006073:Gout / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents