from lindybills thread
Medical News: ACR: Lowering Uric Acid Cuts Cardiac Death Rate
Action Points
* Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
* Point out that the study demonstrates significant associations between urate lowering therapy and improved cardiovascular and stroke mortality but cannot establish causality.
ATLANTA -- There is a significant association between lowering uric acid in patients with high levels and a reduction of their mortality from cardiovascular disease, researchers said here.
During the study period, hyperuricemia patients who were treated with urate lowering drugs such as allopurinol achieved a 44% reduction in death caused by heart disease and a 58% reduction in deaths caused by stroke (P<0.001 for both), according to Jiunn-Horng Chen, MD, PhD, of China Medical University, Taichung, Republic of China (Taiwan).
"Patients with hyperuricemia should be treated more aggressively and persistently than previously thought. This is not only for preventing incident gout, but also for the sake of cardiovascular disease prevention," Chen said at the American College of Rheumatology meeting here.
Noting that previous studies have linked elevated serum uric acid levels and cardiovascular disease, Chen and his colleagues evaluated whether controlling levels with urate lowering therapy -- primarily allopurinol and benzbromarone -- could have an impact on cardiovascular mortality.
The researchers scrutinized medical data on 45,215 people, including 20,677 men and 24,538 women, from a large medical database in Taiwan -- where hyperuricemia is prevalent -- and the National Mortality Registry for Cardiovascular Death.
They sought links to hyperuricemia and urate lowering drug prescriptions and cardiovascular disease, adjusting their findings for a host of demographic and clinical variables.
After 11.26 years of follow-up, Chen said that 519 people died of cardiovascular disease, including 308 men and 211 women.
The overall effects of urate lowering therapy on cardiovascular and stroke mortality were most prominent for reductions in deaths from hemorrhagic stroke (88%, P<0.001) and hypertension (71%, P=0.003).
Additionally, the researchers found that patients who continued treatment for hyperuricemia for more than a year had a much lower risk of developing cardiovascular disease than those who had been treated for less than two months.
"We have observed that there is potential benefit of urate lowering therapy on reducing total cardiovascular disease and stroke mortality," Chen said.
"We saw similar findings in our study of gout patients treated with the urate-lowering drug colchicine," said Michael Pillinger, of New York University. In Pillinger's study, colchicine therapy was associated with a reduction in cardiovascular events.
"Hyperuricemia or gout may carry a cardiovascular risk," he told MedPage Today, suggesting that treatment with urate lowering drug may prevent such events.
He noted that in the last decade the routine assessment of uric acid levels among patients in the U.S. has been discontinued. He said growing data, including that of the Taiwanese groups, makes him consider "that I would like to see uric acid levels included as part of the diagnostic panel."
In Taiwan, about 70% of the population has hyperuricemia, Chen said. In Caucasians about 40% of adults have hyperuricemia. He said the reasons for the differences in levels of hyperuricemia by ethnicity are not fully understood."
medpagetoday.com |
