Gout Cases on the Rise in U.S.
Survey Shows More Than 8 Million Americans Have Gout
Pre-Gout Condition on the Rise continued...
The earlier National Health and Nutrition Examination Survey (NHANES), conducted between 1988 and 1994, involved 18,825 Americans aged 20 and over, 10,009 of whom were women.
The later NHANES survey, carried out in 2007 and 2008, involved 5,707 adults, 2,910 of whom were women.
In addition to the 1.2% increase in gout rates from the earlier to the later time period, the researchers found that the rate of the pre-gout condition known as hyperuricemia is also on the rise.
Over the 20-year study period, the percentage of Americans with hyperuricemia -- an abnormally high level of uric acid in the blood that can sometimes lead to gout -- rose from 18% to 21%, Zhu says.
Obesity and Gout
Zhu says she believes the epidemic of obesity and rising rates of high blood pressure among Americans are largely to blame for the escalating numbers of people with both conditions.
Better management of these risk factors could help stem the tide, she says.
Sundy, who says that he was "disappointed, but not surprised, by the findings," says that many questions remain. "We don't know whether high uric acid contributes to obesity and hypertension, or whether obesity and hypertension contribute to high uric acid, or they are just birds of a feather that travel together.”
Sundy tells WebMD it is doubtful that increased screening and earlier diagnosis may help explain the rise in gout rates, as some experts have suggested.
"Uric acid levels are no longer a standard measure on panels" given when you have blood drawn during your regular physical exam, he explains. "Now it’s a directed measure if a patient has symptoms or the provider otherwise wants to check."
Routine uric acid screens, which were dropped because they were not believed to add "clinically meaningful" information, should be reinstated, Sundy says.
Longer Lives May Affect Gout Rates
The fact that Americans are living longer may be contributing to rising gout rates, Sundy says. "You rarely see gout in women before menopause. But after menopause, uric acid levels, and the risk of developing gout, increases."