title: Increased risk of vascular disease associated with gout: a retrospective, matched cohort study in the UK clinical practice research datalink.
abstract: OBJECTIVE
  To determine whether gout increases risk of incident coronary heart disease (CHD), cerebrovascular (CVD) and peripheral vascular disease (PVD) in a large cohort of primary care patients with gout, since there have been no such large studies in primary care.
  
  
  METHODS
  A retrospective cohort study was performed using data from the Clinical Practice Research Datalink (CPRD). Risk of incident CHD, CVD and PVD was compared in 8386 patients with an incident diagnosis of gout, and 39 766 age, sex and registered general practice-matched controls, all aged over 50 years and with no prior vascular history, in the 10 years following incidence of gout, or matched index date (baseline). Multivariable Cox Regression was used to estimate HRs and covariates included sex and baseline measures of age, Body Mass Index, smoking, alcohol consumption, Charlson comorbidity index, history of hypertension, hyperlipidaemia, chronic kidney disease, statin use and aspirin use.
  
  
  RESULTS
  Multivariable analysis showed men were at increased risk of any vascular event (HRs (95% CIs)) HR 1.06 (1.01 to 1.12), any CHD HR 1.08 (1.01 to 1.15) and PVD HR 1.18 (1.01 to 1.38), while women were at increased risk of any vascular event, HR 1.25 (1.15 to 1.35), any CHD HR 1.25 (1.12 to 1.39), and PVD 1.89 (1.50 to 2.38)) but not any CVD.
  
  
  CONCLUSIONS
  In this cohort of over 50s with gout, female patients with gout were at greatest risk of incident vascular events, even after adjustment for vascular risk factors, despite a higher prevalence of both gout and vascular disease in men. Further research is required to establish the reason for this sex difference.
authors.affiliation: Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, UK.
authors.forename: Lorna E
authors.initials: LE
authors.lastname: Clarson
authors.affiliation: Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, UK.
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Hider
authors.affiliation: Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, UK.
authors.forename: John
authors.initials: J
authors.lastname: Belcher
authors.affiliation: Department of Primary Care Health Sciences, Oxford University, Oxford, UK.
authors.forename: Carl
authors.initials: C
authors.lastname: Heneghan
authors.affiliation: Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, UK.
authors.forename: Edward
authors.initials: E
authors.lastname: Roddy
authors.affiliation: Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, UK.
authors.forename: Christian D
authors.initials: CD
authors.lastname: Mallen
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002561:Cerebrovascular Disorders / Q000453:epidemiology*; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology*; D005260:Female; D006073:Gout / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000453:epidemiology*; D012189:Retrospective Studies; D012737:Sex Factors; D013223:Statistics as Topic; D006113:United Kingdom / Q000453:epidemiology
keywords: Cardiovascular Disease; Epidemiology; Gout