Clinical study
Asymptomatic hyperuricemia. Risks and consequences in the normative aging study

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Abstract

To quantify the consequences of asymptomatic hyperuricemia, this study examined rates for a first episode of gouty arthritis based on 30,147 human-years of prospective observation. A cohort of 2,046 initially healthy men in the Normative Aging Study was followed for 14.9 years with serial examinations and measurement of urate levels. With prior serum urate levels of 9 mg/dl or more, the annual incidence rate of gouty arthritis was 4.9 percent, compared with 0.5 percent for urate levels of 7.0 to 8.9 mg/dl and 0.1 percent for urate levels below 7.0 mg/dl. With urate levels of 9 mg/dl or higher, cumulative incidence of gouty arthritis reached 22 percent after five years. Incidence rates were three times higher for hypertensive patients than for normotensive patients (p <0.01). The strongest predictors of gout in a proportional hazards model were age, body mass index, hypertension, and cholesterol level, and alcohol intake. When the serum urate level became a factor in the model, none of these variables retained independent predictive power. At the final examination, only 0.7 percent of participants had a serum creatinine level of 2.0 mg/dl or more, with no evidence of renal deterioration attributable to hyperuricemia. These data support conservative management of asymptomatic hyperuricemia.

References (27)

  • WB Duffy et al.

    Management of asymptomatic hyperuricemia

    JAMA

    (1981)
  • PA Simpkin

    Management of gout

    Ann Intern Med

    (1979)
  • AB Garrod

    On the blood and effused fluids in gout, rheumatism and Bright's disease

    Trans Med Chir Soc Edinb

    (1854)
  • Cited by (0)

    This work was supported by the Medical Research Service of the Veterans Administration.

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