The anti-inflammatory benefits of a common gout medicine may help save the lives of heart failure patients, researchers say. This could be beneficial for Black Americans, who have a higher risk of gout due to their higher prevalence of risk factors such as obesity, diabetes, chronic kidney disease, and hypertension.
The medication, colchicine, could also reduce the risk of heart attack and stroke in patients whose arteries are clogged with cholesterol, according to the study authors.
How does gout medicine help heart failure?
"The signal for benefit with colchicine in these patients was very impressive, and I expect that these findings will have quite a significant impact on clinical care in heart failure and future research for patients with this condition," Dr. Kenneth Bilchick said in a University of Virginia (UVA) news release. He's a professor of cardiovascular medicine there.
For the study, Bilchick and his team analyzed the records of more than 1,000 patients admitted to the university's Medical Center between March 2011 and February 2020 for worsening heart failure, which occurs when the heart can't pump enough blood through the body.
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Survival rates were nearly 98% for those who received colchicine for a gout flare, compared with less than 94% for those who weren't given colchicine.
Many patients with heart failure also have gout, a type of arthritis caused by a buildup of uric acid crystals in the joints.
Common treatments for gout include colchicine, steroids and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen. However, steroids and NSAIDs are not typically given to heart failure patients because they could worsen heart failure symptoms.
Colchicine may benefit heart failure patients by reducing inflammation in the heart and blood vessels, the researchers suggest.
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While these initial findings need to be confirmed in large studies, the research team say they are promising.
"These results highlight the importance of novel inflammatory mechanisms in heart failure," Bilchick says.
Heart failure is more than just a failure of the pumping function of the heart, says Dr. Sula Mazimba, a UVA School of Medicine researcher and cardiologist. "There are other processes that are involved, especially during an acute hospitalization phase, such as elevated inflammation and neurohormonal process. Many of the therapeutic agents for heart failure target neurohormonal pathways, but few if any target inflammatory pathways," Mazimba notes.
"Colchicine is a medication that has anti-inflammatory properties that could potentially attenuate the heightened inflammation that we see in patients who are hospitalized with heart failure," Mazimba adds.
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How to protect your heart
About 6 million Americans have heart failure and it causes more than 86,000 deaths a year, according to the American Heart Association.
Having gout increases your risk of developing cardiovascular disease, however, there are some things you can do to protect yourself and your heart:
Take your gout medication as prescribed
A third of gout patients stop taking their medication or use it inconsistently. Stopping your medication can leave you vulnerable to gout flares and cardiovascular disease because high uric acid levels may contribute to a variety of heart-related problems, including atherosclerosis (hardening of the arteries).
“For people with gout, there is some evidence that controlling their uric acid level — most commonly with allopurinol — can reduce cardiac risk,” says rheumatologist Theodore R. Fields, MD, Professor of Clinical medicine at Weill-Cornell Medical College and Attending Physician at Hospital for Special Surgery.
Pay attention to your heart
You should have a rheumatologist (or an internist or a cardiologist) regularly check your blood pressure, cholesterol, and blood sugar. You may also benefit from additional tests like an EKG (electrocardiogram), stress test, or a cardiac CT and a statin (cholesterol-lowering medication) depending on your overall cardiovascular risk. Ask your doctor about these.
“The main issue is the fact that many patients with gout have obesity, high blood pressure, diabetes, and abnormal cholesterol,” says Joshua F. Baker, MD, Associate Professor of Rheumatology and Epidemiology at the University of Pennsylvania and the Corporal Michael J. Crescenz VA Medical Center. “It is important that these are identified and treated to prevent the risk of cardiovascular disease. Patients with gout area also at higher risk of developing these conditions over time, so they should be continually monitored for their development.”
Lose weight
Losing even a small amount of weight can do wonders for your heart. Whatsmore, if you manage to cut enough calories from your diet, you can reduce your risk of future gout attacks.
“There is an increased incidence of being overweight in gout patients, so weight loss can be important as a cardiac-preventive strategy in gout patients,” says Dr. Fields.
Try cutting back on purines (substances found in organ meats, certain seafood, soda, and alcohol that your body breaks down into uric acid). This may also reduce gout flares.
Lastly, remember to talk to your health care provider about your personal risk factors, medications, and lifestyle changes you can make to reduce your risk of heart disease.
