In the linked case-control study (doi:10.1136/bmj.d8190), Choi and colleagues assess the association between antihypertensive drugs and the development of incident gout, stratified by the presence of hypertension.1

The link between uric acid and arterial hypertension was first noted in the 1960s, when prospective studies reported that 26% of untreated hypertensive patients with normal renal function had raised serum uric acid concentrations. This figure rose to 58% for those receiving antihypertensive drugs, and it was particularly high in those taking diuretics (70%).2 Since then, raised uric acid concentrations in people with normotensive, borderline, and established hypertension have been shown to be associated with decreased renal blood flow, without affecting glomerular filtration rate, and with increased renal and peripheral resistances. This suggests that unexplained hyperuricaemia …