Abstract 1977: Adiposity, Hypertension, Diuretic Use and Risk of Incident Gout in Women – The Nurses Health Study
H Choi & G. Curhan

Purpose: To investigate prospectively the relationship between adiposity, hypertension, and diuretic use and incident gout in a cohort of 92,224 women who did not have a history of gout at baseline.

Methods: From 1980 on The Nurses Health Study collected data on weight, hypertension, and diuretic use every 2 years, while diet and alcohol use data were collected every 4 years. Cox proportional hazard regression models were used to evaluate the relations among study variables while controlling for a variety of factors including age, meat, dairy, and seafood intake, and use of hormone replacement therapy.

Results: During the 24 years of follow-up, 444 confirmed cases of incident gout were identified. Increased adiposity (fully adjusted relative risks [RR] ranged from 1.55 to 7.25 for the lowest and highest body mass index categories, respectively), hypertension (RR = 2.26), diuretic use (RR = 2.63) were also associated with incident gout.

Conclusions: Factors associated with incident gout are generally in accord with those factors previously identified among men.

Editorial Comments: The strong association between adiposity (with body mass index used as a proxy for body fat) and incident gout among women in this large, well-characterized cohort is of concern given the ever increasing prevalence of obesity among US women. Moreover, obesity itself promotes both hypertension and the increased use of diuretic medications which, themselves, also associate independently with incident gout. What is not determined from this study is whether the prevalence of incident gout among women has increased over the same time period as has the increased prevalence of overweight and obesity. Nonetheless, this study indicates that to reduce incident gout and its associated burden and co-morbidities, it is critical to develop better interventions to control weight and more effective ways to promote sustained weight loss among previously overweight and obese women.

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