Gout and Heart Disease: A Two-Way Street?

Abstract Gout is the most common inflammatory rheumatic disease, with an increasing incidence, and is characterized by the deposition of monosodium urate crystals in the joints, skin, and kidneys. As in other inflammatory diseases, for example, rheumatoid arthritis, gout is considered a condition associated with an increased cardiovascular risk. The origin of this increase appears to be two-fold; first, traditional risk factors such as dyslipidemia, hypertension, smoking, obesity, and diabetes mellitus are more prevalent in gout patients compared with the general population. Secondly there is strong evidence that gout and hyperuricemia are independent risk factors for cardiovascular disease. The increased cardiovascular risk in gout patients implies that nearly all of these patients are eligible for cardiovascular risk management, including screening and treating traditional risk factors. Observational data suggest a beneficial effect of urate-lowering therapy on cardiovascular risk.