Amlodipine Linked to Lower Risk of Gout

January 30, 2020

Amlodipine lowered long-term gout risk, compared with lisinopril or chlorthalidone, in older adults with hypertension, according to a study published in the Journal of Hypertension.

“Our study is clinically relevant as the prevalence of gout has been rising in the United States and the number of Americans meeting newly-revised diagnostic thresholds for hypertension has doubled,” said Stephen Juraschek, MD, Beth Israel Deaconess Medical Center, Boston, Massachusetts. “Our study demonstrated that amlodipine was associated with a lower risk of gout compared with chlorthalidone or lisinopril, which has never been reported prior to this study.”

For the study, Dr. Juraschek and colleagues analysed data from patients who participated in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). ALLHAT was a randomised study on the effects of first-step hypertension therapy with amlodipine, chlorthalidone, or lisinopril on fatal coronary heart disease or nonfatal myocardial infarction.

Trial participants were linked to gout claims using ICD codes. Over a mean follow-up time of 4.9 years, there were a total of 597 gout claims.

Amlodipine reduced the risk of gout by 37% (hazard ratio [HR] = 0.63; 95% confidence interval [CI], 0.51-0.78) and chlorthalidone reduced the risk of gout by 26% (HR = 0.74; 95% CI, 0.58-0.94). Lisinopril non-significantly lowered gout risk compared with (HR = 0.85; 95% CI, 0.70-1.03). Gout risk reduction was primarily observed after 1 year of follow-up.

“This finding may be useful in cases where gout risk is a principal concern among patients being treated for hypertension,” said Dr. Juraschek.

“Further research is needed to confirm these findings,” he added. “Other health outcomes, such as heart failure, should also be considered with choosing a blood pressure drug.”


SOURCE: Beth Israel Deaconess Medical Center