AB1065 EARLIER ONSET OF ARTERIAL HYPERTENSION IS A RISK FACTORS FOR SEVERE COURSES OF GOUT

Abstract

BackgroundComorbidities cardiovascular disease such as arterial hypertension (AH) are common in people with gout and complicate its management and disease outcomes.ObjectivesOur purpose was to evaluate the effect of AH on the severity of gout.MethodsWe included data of 286 male patients with gout: median (Ме) age 51.2 [interquartile range (IR) 42.8;59.4] years (ys), disease duration – Ме 6.2 [IR 3.8;12.1] ys, number of joints involved during disease course – Ме 7 [IR 4;12], subcutaneous tophi – in 35% pts, intraosseous tophi – in 44% pts. All pts underwent standard clinical examination. AH was defined using by 2018 ESC/ESH Guidelines for the management of arterial hypertension criteria: elevated blood pressure (BP) (systolic BP≥140 or diastolic BP≥90 mm Hg or treatment for hypertension).ResultsAH was found in 244 out of the 286 pts (85 %). AH was diagnosed before gout in 129 (52.9%) pts, and after gout - in 115 (47.1%) pts. The 1st degree of AH was found in 27 (11%), the 2nd degree – in 62 (25%), the 3rd degree – in 155 (64%) pts. AH developed at a younger age in patients with 3rd degree AH compared to patients with 2nd and 3rd degree AH, but did not reach statistical significance. Patients with 3rd degree of AH had longer gout and AH duration compared to patients with 1st and 2nd degree of AH. They had higher prevalence of subcutaneous and intraosseous tofuses, nephrolithiasis compared with the 1st and 2nd degree of AH, p<0.05 (Table 1).Table 1.ParametersGrade 1 hypertensionGrade 2 hypertensionGrade 3 hypertensionAge of gout onset,ys41.6[34.4; 53.5]39.6[35.6; 48.0]•44.1[36.9; 52.6]Age of AH onset,ys44.9[37.4; 55.4]43.6[36.9; 49.9]40.4[29.9; 49.9]Gout duration,ys3.8[1.6; 5.8]5.6[3.8; 13.5]8.0[4.8; 14.6]*AH duration,ys0.1[0; 2.0]3.3[0.2; 9.8]11.3[4.7; 22.8]*Number of joints involved,n4.0[2.0; 6.0]7.0[4.0; 10.0]9,0[5,0; 14.0]*Subcutaneous tophi,%4(14.8%)16(26%)69(44.5%)*Intraosseous tophi,%5(18.5%)29(47%)83(53.5%)*Nephrolithiasis,%16(59%)34(55%)124(80%)*Data are presented in median values and IR (unless otherwise noted), •p<0,05 reliability of differences for trend, *p<0,05 compared vs group 3 (Mann -Whitney).AH preceded the development of gout in 26% pts with 1st degree of AH, in 42% pts with 2nd degree of AH, in 62% pts with 3rd degree of AH.ConclusionHypertension preceded the development of gout in 62% patients with 3rd degree of AH. They had a more severe course of gout compared to patients with 1st and 2nd degree of AH. It can be assumed that an earlier onset of AH is a risk factor for severe courses of gout.Disclosure of InterestsNone declared