July 13, 2006

Diuretic use implicated in gout attacks

NEW YORK (Reuters Health) - Taking a diuretic or 'water
pill' for heart failure or to lower blood pressure seems to
more than triple the risk of suffering recurrent bouts of gout,
according to a new report.

Gout is caused by deposition of urate crystals in joints,
often the big toe joint. A link between diuretic use and
excessive uric acid in the blood was established more than four
decades ago, Dr. David J. Hunter, from Boston University School
of Medicine, and colleagues note in The Journal of

However, until now, no studies have specifically
investigated whether taking diuretics actually raises the risk
of recurrent gout attacks.

The present study involved 197 patients, recruited over the
Internet, who had a gout attack in the past year and agreed to
allow access to their medical records.

Eighty percent of subjects were male and most had a college
education. The researchers focused on diuretic use in the two
days preceding a gout attack.

Overall, recent diuretic use appeared to increase the
probability of recurrent gout attacks by 3.6-fold, the report

The team suggests that the answer is to avoid prescribing
diuretics to people prone to gout. "Given the wide availability
of alternative effective agents for the treatment of
hypertension and congestive heart failure," they say,
"clinicians have ample ability to individualize management for
this population."

SOURCE: Journal of Rheumatology, July 2006.