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Antihypertensives in people with gout or asymptomatic hyperuricaemia

BMJ 2012; 344 doi: (Published 12 January 2012) Cite this as: BMJ 2012;344:d7961
  1. Luis M Ruilope, chief
  1. 1Hypertension Unit, Hospital 12 de Octubre and Department of Preventive Medicine and Public Health, University Autonoma, 28041 Madrid, Spain
  1. ruilope{at}

Losartan and calcium channel blockers are most effective owing to their uricosuric properties

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 …

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