Amlodipine better BP drug for lower long-term risk for gout

(HealthDay)—The antihypertensive medication amlodipine is associated with a lower risk for gout compared with other antihypertensive agents, according to a study published online Jan. 20 in the Journal of Hypertension.

Stephen P. Juraschek, M.D., Ph.D., from Harvard Medical School in Boston, and colleagues examined the relationship between antihypertensives and gout using data from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial, a randomized clinical trial that measured the effects of amlodipine, chlorthalidone, and lisinopril on fatal coronary heart disease and nonfatal myocardial infarction. The authors linked trial data for 23,964 participants to gout claims from the Centers for Medicare & Medicaid Services and Veterans Affairs.

The researchers found that compared with chlorthalidone and lisinopril, amlodipine was associated with a 37 and 26 percent lower risk for gout, respectively (hazard ratios, 0.63 [95 percent confidence interval, 0.51 to 0.78] and 0.74 [95 percent confidence interval, 0.58 to 0.94]), respectively). Compared with chlorthalidone, lisinopril also was associated with lower gout risk, although this difference was not significant (hazard ratio, 0.85; 95 percent confidence interval, 0.70 to 1.03). Treatment with atenolol was not associated with gout risk (hazard ratio, 1.18; 95 percent confidence interval, 0.78 to 1.80). The reduction in gout risk was mostly observed after one year of follow-up.

"Our study is clinically relevant as the prevalence of gout has been rising in the United States and the number of Americans meeting newly-revised diagnostic thresholds for hypertension has doubled," Juraschek said in a statement. "Our study demonstrated that amlodipine was associated with a lower risk of gout compared with chlorthalidone or lisinopril, which has never been reported prior to this study."