Antihypertensive drugs and risk of incident gout among patients with hypertension: population based case-control study
Objective To determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension.Design Nested case-control study.Setting UK general practice database, 2000-7.Participants All incident cases of gout (n=24 768) among adults aged 20-79 and a r...
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| Published in | BMJ Vol. 344; no. 7843; p. 18 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
British Medical Journal Publishing Group
12.01.2012
BMJ Publishing Group BMJ Publishing Group LTD BMJ Publishing Group Ltd |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0959-8138 1756-1833 1468-5833 1756-1833 |
| DOI | 10.1136/bmj.d8190 |
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| Abstract | Objective To determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension.Design Nested case-control study.Setting UK general practice database, 2000-7.Participants All incident cases of gout (n=24 768) among adults aged 20-79 and a random sample of 50 000 matched controls.Main outcome measure 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. |
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| AbstractList | Objective To determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension. Design Nested case-control study. Setting UK general practice database, 2000-7. Participants All incident cases of gout (n=24 768) among adults aged 20-79 and a random sample of 50 000 matched controls. Main outcome measure 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. To determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension. Nested case-control study. UK general practice database, 2000-7. All incident cases of gout (n = 24,768) among adults aged 20-79 and a random sample of 50,000 matched controls. Relative risk of incident gout associated with use of antihypertensive drugs. 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). 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. STUDY QUESTION What are the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension? SUMMARY ANSWER 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. WHAT IS KNOWN AND WHAT THIS PAPER ADDS Hypertension is a common comorbidity of gout, affecting up to 74% of patients with gout. This study provides large scale evidence forthe independent differential effect of antihypertensive drugs for and against the risk of gout. To determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension.OBJECTIVETo determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension.Nested case-control study.DESIGNNested case-control study.UK general practice database, 2000-7.SETTINGUK general practice database, 2000-7.All incident cases of gout (n = 24,768) among adults aged 20-79 and a random sample of 50,000 matched controls.PARTICIPANTSAll incident cases of gout (n = 24,768) among adults aged 20-79 and a random sample of 50,000 matched controls.Relative risk of incident gout associated with use of antihypertensive drugs.MAIN OUTCOME MEASURERelative risk of incident gout associated with use of antihypertensive drugs.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).RESULTSAfter 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).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.CONCLUSIONSCompatible 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. OBJECTIVE: To determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension. Design Nested case-control study. Setting UK general practice database, 2000-7. Participants All incident cases of gout (n=24 768) among adults aged 20-79 and a random sample of 50 000 matched controls. MAIN OUTCOME MEASURE: 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 beta 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, beta blockers, angiotensin converting enzyme inhibitors, and non-losartan angiotensin II receptor blockers are associated with an increased risk of gout. Objective To determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension. Design Nested case-control study. Setting UK general practice database, 2000-7. Participants All incident cases of gout (n=24 768) among adults aged 20-79 and a random sample of 50 000 matched controls. Main outcome measure 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. |
| Author | Soriano, Lucia Cea Rodríguez, Luis A García Choi, Hyon K Zhang, Yuqing |
| Author_xml | – sequence: 1 givenname: Hyon K surname: Choi fullname: Choi, Hyon K email: hchoius@bu.edu organization: Spanish Centre for Pharmacoepidemiological Research (CEIFE), Madrid, Spain – sequence: 2 givenname: Lucia Cea surname: Soriano fullname: Soriano, Lucia Cea email: hchoius@bu.edu organization: Spanish Centre for Pharmacoepidemiological Research (CEIFE), Madrid, Spain – sequence: 3 givenname: Yuqing surname: Zhang fullname: Zhang, Yuqing email: hchoius@bu.edu organization: Spanish Centre for Pharmacoepidemiological Research (CEIFE), Madrid, Spain – sequence: 4 givenname: Luis A García surname: Rodríguez fullname: Rodríguez, Luis A García email: hchoius@bu.edu organization: Spanish Centre for Pharmacoepidemiological Research (CEIFE), Madrid, Spain |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/22240117$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | Choi et al 2012 BMJ Publishing Group Ltd 2012 Copyright: 2012 © Choi et al 2012 Choi et al 2012 2012 Choi et al |
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| DOI | 10.1136/bmj.d8190 |
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| Snippet | Objective To determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension.Design Nested... Objective To determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension. Design Nested... STUDY QUESTION What are the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension? SUMMARY ANSWER... To determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension. Nested case-control study.... To determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension.OBJECTIVETo determine the... OBJECTIVE: To determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension. Design Nested... Objective To determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension. Design Nested... |
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| SubjectTerms | Adult Aged Aged, 80 and over Alcoholic beverages Angiotensin Angiotensin II Antihypertensive Agents - adverse effects Antihypertensive Agents - therapeutic use Antihypertensives Blood pressure Body mass Body mass index Calcium Case control studies Chemotherapy Degenerative joint disease Diuretics Drug development Drugs Drugs: cardiovascular system Drugs: CNS (not psychiatric) Drugs: musculoskeletal and joint diseases Epidemiologic studies Female Follow-Up Studies General practice / family medicine Gout Gout - chemically induced Gout - epidemiology Humans Hypertension Hypertension - drug therapy Hypertension - epidemiology Incidence Male Metabolic disorders Metabolism Middle Aged Musculoskeletal syndromes Peptidyl-dipeptidase A Pharmaceutical preparations Population Population studies Population Surveillance Population-based studies Prognosis Retrospective Studies Rheumatism Risk assessment Risk Factors United Kingdom - epidemiology Uric acid Young Adult |
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| Title | Antihypertensive drugs and risk of incident gout among patients with hypertension: population based case-control study |
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