Gout Cases on the Rise in U.S.
Survey Shows More Than 8 Million Americans Have Gout
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."
Age is a risk factor for both men and women, he says. "You can go years with hyperuricemia and no symptoms. But at some point, enough uric acid accumulates to have a flare-up of gout, so if you're living longer you are more likely to reach that threshold."
Sundy says the fact that the study relied on patients recalling whether a doctor ever told them they had gout -- a method some say is subject to inaccurate memories -- was not a major drawback. "It's not the gold standard, but it turns out patient reports of doctor diagnoses are pretty accurate and, with such large numbers, not likely to alter the findings."
This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.