Clarson, LE and Hider, SL and Belcher, J and Heneghan, C and Roddy, E and Mallen, CD (2015) Increased risk of vascular disease associated with gout: a retrospective, matched cohort study in the UK clinical practice research datalink. Annals of the Rheumatic Diseases, 74 (4). 642 - 647. ISSN 1468-2060

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Abstract

OBJECTIVES: To determine whether gout increases risk of incident coronary heart disease (CHD), cerebrovascular (CVD) and peripheral vascular disease (PVD) in a large cohort of primary care patients with gout, since there have been no such large studies in primary care. METHODS: A retrospective cohort study was performed using data from the Clinical Practice Research Datalink (CPRD). Risk of incident CHD, CVD and PVD was compared in 8386 patients with an incident diagnosis of gout, and 39 766 age, sex and registered general practice-matched controls, all aged over 50 years and with no prior vascular history, in the 10 years following incidence of gout, or matched index date (baseline). Multivariable Cox Regression was used to estimate HRs and covariates included sex and baseline measures of age, Body Mass Index, smoking, alcohol consumption, Charlson comorbidity index, history of hypertension, hyperlipidaemia, chronic kidney disease, statin use and aspirin use. RESULTS: Multivariable analysis showed men were at increased risk of any vascular event (HRs (95% CIs)) HR 1.06 (1.01 to 1.12), any CHD HR 1.08 (1.01 to 1.15) and PVD HR 1.18 (1.01 to 1.38), while women were at increased risk of any vascular event, HR 1.25 (1.15 to 1.35), any CHD HR 1.25 (1.12 to 1.39), and PVD 1.89 (1.50 to 2.38)) but not any CVD. CONCLUSIONS: In this cohort of over 50s with gout, female patients with gout were at greatest risk of incident vascular events, even after adjustment for vascular risk factors, despite a higher prevalence of both gout and vascular disease in men. Further research is required to establish the reason for this sex difference.

Item Type: Article
Additional Information: Published Open Access, CC-BY-NC
Uncontrolled Keywords: cardiovascular disease, cerebrovascular disorders, cohort studies, coronary disease, epidemiology, female, gout, great britain, humans, male, middle aged, peripheral vascular diseases, retrospective studies, sex factors, statistics as topic
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Related URLs:
Depositing User: Symplectic
Date Deposited: 15 Dec 2015 09:40
Last Modified: 15 Dec 2015 09:40
URI: http://eprints.keele.ac.uk/id/eprint/1293

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