Antihypertensive drug amlodipine lowers long-term risk of gout

A large-scale study published in the Journal of Hypertension Jan. 20 suggests the calcium channel blocker amlodipine can lower hypertensive patients’ BP while simultaneously minimizing their long-term risk of developing gout.

The study, penned by Stephen Juraschek, MD, PhD, of Beth Israel Deaconess Medical Center, and colleagues looked to determine whether any of three blood pressure-lowering drugs—amlodipine, chlorthalidone and lisinopril—could reduce hypertensive patients’ odds of developing gout down the line. The authors explained that gout is often described in the context of food consumption, but it’s actually also a common complication of blood pressure management and one of the most-cited reasons hypertensive patients avoid taking their BP medications.

Juraschek et al. said there’s little scientific literature that helps inform antihypertensive selection with regard to gout risk, so they undertook an analysis of 23,964 patients enrolled in the ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack) trial. Participants were treated across 623 medical centers between 1994 and 2002 and linked to CMS and VA gout claims after the fact.

The authors identified 597 gout claims over the course of five years of follow-up, finding in the process that amlodipine reduced patients’ risk of gout by 37% compared with chlorthalidone. It also reduced gout risk by 26% when compared with lisinopril.

“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 release. “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.”

According to the team’s results, lisinopril didn’t significantly lower gout risk compared with chlorthalidone. Use of the beta-blocker atenolol—taken by 928 patients in the study—wasn’t associated with gout risk at all.

“Further research is needed to confirm these findings,” Juraschek said. “Other health outcomes, such as heart failure, should also be considered with choosing a blood pressure drug.”