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 acid是心血管风险和炎症的标志，且水平的升高与AFib独立相关。
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
如果你有痛风，你需要考虑你的心脏健康。患有AFib会增加血栓、心力衰竭和中风等严重疾病的风险。
“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.
你的初级保健医生或心脏病专家可以通过心电图(EKG)、动态心电图(Holter monitor)和其他测试来诊断AFib。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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