Hypertension predicts an increased risk of gout among middle-aged African-American and white adults independent of gout risk factors and regardless of gender, race, or obesity, according to a new study.

Researchers speculate that serum urate levels may be a partial intermediate on the pathway between hypertension and gout.

In an analysis of data from 10,872 participants in the population-based Atherosclerosis Risk in Communities (ARIC) study, Mara A. McAdams-DeMarco, MS, PhD, and colleagues found that hypertension was associated a twofold increased risk of gout after adjusting for confounders. When the investigators further adjusted for serum urate level, hypertension was associated with a 36% increased risk. The researchers observed no effect of gender, race, or obesity at baseline on gout risk, the researchers reported in The Journal of Clinical Hypertension (2012;14:675-679).

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Of the 10,872 subjects, 45% had hypertension during follow-up. Over nine years, gout developed in 274 subjects (2.5%).

“The biological mechanism linking hypertension and gout is thought to be through kidney function,” the authors wrote. “The excretion of uric acid occurs primarily via the kidney.”

Additionally, they observed that hypertension is a component of the metabolic syndrome, which has been associated with gout development.