gout and atrial fibrillation

The Link Between Gout and Atrial Fibrillation

What does a disease that inflames your joints have to do with an erratic heart rhythm? Quite a lot, it turns out. Researchers have discovered thatpeople with goutare at increased risk for atrial fibrillation (AFib).

One recent study analyzed a sample of Medicare claims data from more than 1.6 million people ages 65 and older. Those with gout were up to 90 percent more likely to be diagnosed with AFib than those without gout. The risk was particularly high among elderly adults.

The potential link between the two conditions underscores the need for gout patients to pay attention to theirheart health.

What’s Behind the Link?

痛风和AFib之间最明显的联系是炎症。全身炎症是这两种疾病的标志。The two conditions also share a number of risk factors, includingobesity, high blood pressure, anddiabetes.

Uric acid is another factor AFib and gout have in common. Gout occurs when high uric acid levels in the blood cause hard crystals to form around joints.Uric acidis a marker for cardiovascular risk and inflammation, and increased levels have been independently linked to AFib.

尽管如此,研究人员仍很难证明痛风与afib联系的确切原因。炎症会是潜在的联系吗?当然。尿酸会是炎症的诱因吗?当然。还有其他因素吗?当然可以,”医学博士、公共卫生硕士、阿拉巴马大学医学和流行病学教授、医疗保险索赔研究的合著者Jasvinder Singh说。“我们需要调查所有这些途径,以便更好地理解这一点。”

Getting a Diagnosis

If you have gout, you need to think about your heart health. Having AFib can increase your risk for serious conditions like blood clots, heart failure, and stroke.

“I think the practical implication is that rheumatologists and primary care doctors should keep a heightened suspicion for arrhythmias [abnormal heart rhythms] in people with gout,” Dr. Singh says. Vigilance is particularly important for people who have other AFib risk factors, such as high blood pressure or coronary artery disease.

Your primary care doctor or cardiologist can diagnose AFib with an electrocardiogram (EKG), Holter monitor, and other tests. If you have the condition,treatmentsinclude medicines and devices to control your heart rate and rhythm, and drugs to prevent blood clots from forming.

Treating Gout to Protect Your Heart

The samemedications that treat goutmight do double duty by lowering your AFib risk. In a 2016 study Dr. Singh also co-authored, older adults who took allopurinol had a 17 percent lower risk of AFib. Among those who took the drug for more than 2 years, the risk dropped by 35 percent. Colchicine is also being investigated for lowering AFib risk.

The trouble is, less than half of people with gout stick to their treatment regimen, putting both their joints and heart at risk. “These studies are increasingly making the case that if patients have gout, they should get treatment for it. Treatment might also protect them from the cardiac condition,” Dr. Singh says.

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spinal gout arthritis pain

你的背痛可能是痛风吗?

If you have ever hadback pain, you know how difficult it can be to pinpoint the cause. From bone spurs to overworked muscles to slipped discs, there’s no shortage of ailments that could be at the root of your aching lumbar.

And here’s one more. Over the last 10 years, rheumatologists have documented more cases of gout appearing in the spine. So if you are one of the 8 million Americans with this inflammatory form of arthritis – and you have unexplained back or neck pain, tingling sensations down your arm or leg, or numbness – there’s a small chancethe culprit could be your gout.

Continue reading你的背痛可能是痛风吗?

foods to eat and avoid for gout management

What to Eat and Avoid for Gout

Food choices plays an important role inmanaging gout, the most common form of inflammatory arthritis in the United States. Gout occurs when uric acid builds up in the blood (instead of being excreted) and gets deposited as crystals in one or more joints, triggering sudden swelling and pain. Uric acid is a by-product of the breakdown of purines, naturally occurring compounds in the body and in certain foods, which is why diet can be important for controlling gout attacks.

We asked rheumatologist Hyon K. Choi, MD, a gout expert and Professor of Medicine at Harvard Medical School, what people with gout should know about diet.

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Gout and OA—What’s the Connection?

A swollen, stiff knee might immediately lead you to suspect you haveosteoarthritis (OA), but the culprit could also be gout. Like many close relatives, the two conditions share common features. And because they often occur together, you might wonder which one is causing your symptoms.

“人们完全有可能同时患有这两种疾病。它们是两种最常见的关节炎,”纽约大学朗格尼健康中心风湿病部门的助理医学教授Svetlana Krasnokutsky博士说。“它们会影响相同的关节。”

Continue readingGout and OA—What’s the Connection?

eat less meat - gout diet

Making Smart Meat Choices If You Have Gout

If you’re changing your diet to help lower uric acid levels andreduce your risk of gout attacks, meat choices can have a big impact. Some meats are high in purines. Purines are substances found naturally in the body as well as in in foods. They are broken down in the body to form uric acid. When excess uric acid in the bloodstream builds too quickly or can’t be eliminated fast enough, it is deposited as needle-shaped crystals in the tissues of the body, including joints, causing intense pain. So, a high-purine diet puts you at greater risk for uric acid buildup. And a 2012 study in theAnnals of the Rheumatic Diseasesshowed that the risk worsens as more purines are included in the diet. But what if meats are your favorite food? Here’s what you should know about your options.

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dash diet for gout

Heart Diet Good for Gout

A diet that’s best known for promoting heart health may also help gout management. The Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fresh fruits and vegetables, whole grains and low-fat dairy products, may lower serum uric acid (SUA) levels. In a study published inClinical Rheumatologyin March 2017, research findings showed that the diet reduced SUA [compared to the typical American (control) diet] within 30 days, with a sustained effect at 90 days. In an earlier study reported inArthritis & Rheumatologyin August 2016, researchers reported similar finding in some cases.

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Gout News Medication Risk

Increasing Allopurinol Dose May Better Control Gout

In addition to being treated with medication for symptoms of an acute flare, should a person with gout be put on long-term uric acid-lowering medication to reduce future flares? And is it safe to keep raising the dose of the medication until uric acid drops below a specified target? Rheumatologists and other physicians are currently grappling with those questions, and a new study may help lead to some answers.

What Is Gout?

Goutis the most common form of inflammatory arthritis in the United States, affecting more than 8 million adults. It develops in some people who have high levels of uric acid in the blood. Needle-shaped crystals form in and around joints – often beginning in the base of the big toe – causing episodes of severe pain, heat and swelling.
Continue readingIncreasing Allopurinol Dose May Better Control Gout

Gout and Premature Death Risk

People with Gout at Risk of Premature Death

A new study found that people with gout have a 25 percent greater likelihood of dying prematurely than people without gout. The findings also show that this increased mortality rate has not improved over the past 16 years, unlike the mortality rate for people with rheumatoid arthritis (RA).

Gout, which affects more than 4 percent of adults in the United States, is the most common form of inflammatory arthritis. It develops in some people who have high levels of uric acid in the blood. The acid can form needle-like crystals in a joint and cause sudden, severe episodes of pain, tenderness, redness, warmth and swelling. Gout is also associated with other illnesses, such as cardiovascular disease and metabolic syndrome.
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Gout Treat to Target

Panel Recommends Aggressive Treat-to-Target Approach to Gout

An international panel of leading gout experts has published new recommendations advising that doctors use a treat-to-target approach for managinggout, a painful form of arthritis that affects more than 8 million adults in the United States. Central to the recommendations is using medication to reduce and keep blood uric acid levels below 6 milligrams per deciliter (mg/dL) – and even lower in people with severe gout. The recommendations were published online inAnnals of the Rheumatic Diseasesin September.
Continue readingPanel Recommends Aggressive Treat-to-Target Approach to Gout