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Calcium channel blockers and losartan best for those at risk of gout, say researchers

Calcium channel blockers and the angiotensin receptor blocker, losartan, are the best antihypertensives to use in patients at risk of gout, say researchers.

In the first large-scale evidence to assess the risk of incident gout with various antihypertensives, researchers looked at 24,768 cases of gout recorded in the UK general practice between 2000 and 2007 and compared them with 50,000 matched controls.

After adjusting for age, sex, BMI, GP visits, alcohol intake, other drugs and comorbidities, researchers found that the relative risk of gout in hypertensive patients currently taking antihypertensives (29,138 patients) was lowest for calcium channel blockers and losartan – at 0.87 and 0.81 respectively.

This compared with 2.36 for diuretics, 1.48 for beta-blockers, 1.24 for ACE inhibitors and 1.29 for non-losartan ARBs.

These findings are compatible with other research showing that calcium channel blockers and losartan have urate lowering properties and study lead Professor Hyon Choi, Professor of medicine at Boston University, US, said that the findings would have practical implications for the management of patients with hypertension.

‘Using these urate lowering antihypertensive drugs could help reduce the high co-morbidity burden of gout and hypertension.’

 BMJ 2012,published online  12 January