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chronic process and could therefore occur during either a haz- ard or control period.

In summary, we found that recent use of thiazide and pos- sibly loop diuretics was associated with a significantly increased risk for recurrent gouty arthritis. Despite the well known association of gout and diuretics, a relatively large pro- portion of our patient population with preexisting gout was prescribed this class of antihypertensive therapy. Given the wide availability of alternative effective agents for the treat- ment of hypertension and congestive heart failure, clinicians have ample ability to individualize management for this pop- ulation, and could reduce risk of recurrent gout attacks by avoiding the use of thiazide and possibly loop diuretics in per- sons with preexisting gout.


  • 1.

    Lawrence RC, Helmick CG, Arnett FC, et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum 1998;41:778-99.

  • 2.

    Bieber JD, Terkeltaub RA. Gout: on the brink of novel therapeutic options for an ancient disease. Arthritis Rheum 2004;50:2400-14.

  • 3.

    Gutman AB. The past four decades of progress in the knowledge of gout, with an assessment of the present status. Arthritis Rheum 1973;16:431-45.

  • 4.

    Terkeltaub RA. Clinical practice. Gout. N Engl J Med 2003;349:1647-55.

  • 5.

    Wallace SL, Singer JZ. Review: systemic toxicity associated with the intravenous administration of colchicine — guidelines for use. J Rheumatol 1988;15:495-9.

  • 6.

    Roubenoff R, Klag MJ, Mead LA, Liang KY, Seidler AJ, Hochberg

    • MC.

      Incidence and risk factors for gout in white men. JAMA 1991;266:3004-7.

  • 7.

    Hochberg MC, Thomas J, Thomas DJ, Mead L, Levine DM, Klag MJ. Racial differences in the incidence of gout. The role of hypertension. Arthritis Rheum 1995;38:628-32.

  • 8.

    Campion EW, Glynn RJ, DeLabry LO. Asymptomatic hyperuricemia. Risks and consequences in the Normative Aging Study. Am J Med 1987;82:421-6.

  • 9.

    Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Alcohol intake and risk of incident gout in men: a prospective study. Lancet 2004;363:1277-81.

  • 10.

    Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med 2004;350:1093-103.

  • 11.

    Oren B, Rich M, Belle M. Chlorothiazide (Diuril) as a hyperuricacidemic agent. JAMA 1958;168:2128-9.

Hunte , et al: Diuretics and recurrent gout

  • 12.

    Laragh JH, Cannon PJ, Stason WB, Heinemann HO. Physiologic and clinical observations on furosemide and ethacrynic acid. Ann NY Acad Sci 1966;139:453-65.

  • 13.

    Choi HK, Atkinson K, Karlson EW, Curhan G. Obesity, weight change, hypertension, diuretic use, and risk of gout in men: the health professionals follow-up study. Arch Intern Med 2005;165:742-8.

  • 14.

    Gurwitz JH, Kalish SC, Bohn RL, et al. Thiazide diuretics and the initiation of anti-gout therapy. J Clin Epidemiol 1997;50:953-9.

  • 15.

    Waller PC, Ramsay LE. Predicting acute gout in diuretic-treated hypertensive patients. J Hum Hypertens 1989;3:457-61.

  • 16.

    Rott KT, Agudelo CA. Gout. JAMA 2003;289:2857-60.

  • 17.

    Grodzicki T, Palmer A, Bulpitt CJ. Incidence of diabetes and gout in hypertensive patients during 8 years of follow-up. The General Practice Hypertension Study Group. J Hum Hypertens 1997;11:583-5.

  • 18.

    Izzo JL Jr. Hypertension in the metabolic syndrome and diabetes: pathogenesis, clinical studies, and treatment. J Clin Hypertens 2003;5 Suppl 4:3-10.

  • 19.

    Salvetti A, Ghiadoni L. Guidelines for antihypertensive treatment: an update after the ALLHAT study. J Am Soc Nephrol 2004;15 Suppl 1:S51-S54.

  • 20.

    Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. JAMA 2003;290:199-206.

  • 21.

    Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003;42:1206-52.

  • 22.

    Mosby’s Drug Consult. Top 200 most prescribed drugs of 2003. New York: Elsevier; 2003. [Internet]. Available from: http://www.mosbysdrugconsult.com/DrugConsult/Top_200/. Accessed April 6, 2006.

  • 23.

    Wallace SL, Robinson H, Masi AT, Decker JL, McCarty DJ, Yu TF. Preliminary criteria for the classification of the acute arthritis of primary gout. Arthritis Rheum 1977;20:895-900.

  • 24.

    Wolfram G, Colling M. [Total purine content in selected foods.] Z Ernahrungswiss 1987;26:205-13.

  • 25.

    Greenland S. A unified approach to the analysis of case-distribution (case-only) studies. Stat Med 1999;18:1-15.

  • 26.

    Tykarski A. Evaluation of renal handling of uric acid in essential hypertension: hyperuricemia related to decreased urate secretion. Nephron 1991;59:364-8.

  • 27.

    Malawista SE, Van Blaricom G, Cretella SB, Schwartz ML. The phlogistic potential of urate in solution: studies of the phagocytic process in human leukocytes. Arthritis Rheum 1979;22:728-36.

  • 28.

    Ferdinand KC. Recommendations for the management of special populations: racial and ethnic populations. Am J Hypertens 2003;16(11 Pt 2):50S-54S.


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