Department of Family Medicine, School of Medicine, University of Missouri - Kansas City, Kansas City, MO.
J Clin Hypertens (Greenwich). 2014 Dec;16(12):864-8. doi: 10.1111/jch.12413. Epub 2014 Sep 25.
This study assessed the risk of new-onset gout following prescribing of hydrochlorothiazide (HCTZ) compared with chlorthalidone (CTD). This retrospective cohort analysis used administrative claims from 2000 to 2012 to identify patients aged 18 to 89 years with hypertension who were prescribed CTD or HCTZ. Patients were excluded if they had a prior diagnosis of gout, conditions or prescription claims for medications that alter risk of gout, or if they switched between these two diuretics. A total of 1011 patients prescribed CTD were matched with 2022 patients prescribed HCTZ based on age, sex, and Chronic Condition Indicator. New-onset gout occurred in 17 of 1011 (1.68%) patients in the CTD group and in 26 of 2022 (1.29%) patients in the HCTZ group (P=.27). The number of days to first occurrence of gout was 183.6 days and 152.7 days in the CTD and HCTZ groups, respectively (P=.39). The mean daily dose was 22.7 mg for CTD and 24.3 mg for HCTZ, and the median dose of both CTD and HCTZ was 25 mg at the time of new-onset gout. Patients prescribed CTD for hypertension have a similar risk of developing new-onset gout compared with patients prescribed similar doses of HCTZ.
本研究评估了与氯噻酮（CTD）相比，氢氯噻嗪（HCTZ）处方后新发痛风的风险。这项回顾性队列分析使用了 2000 年至 2012 年的行政索赔数据，以确定年龄在 18 至 89 岁之间的高血压患者，这些患者被处方 CTD 或 HCTZ。如果患者有痛风的既往诊断、改变痛风风险的药物的条件或处方索赔，或者如果他们在这两种利尿剂之间切换，则将其排除在外。根据年龄、性别和慢性病指标，将 1011 名被处方 CTD 的患者与 2022 名被处方 HCTZ 的患者进行匹配。在 CTD 组的 1011 名患者中有 17 名（1.68%）发生新发痛风，在 HCTZ 组的 2022 名患者中有 26 名（1.29%）发生新发痛风（P=.27）。痛风首次发生的天数分别为 CTD 组的 183.6 天和 HCTZ 组的 152.7 天（P=.39）。CTD 的平均日剂量为 22.7mg，HCTZ 的平均日剂量为 24.3mg，新发痛风时 CTD 和 HCTZ 的中位剂量均为 25mg。与处方相似剂量 HCTZ 的患者相比，处方 CTD 治疗高血压的患者新发痛风的风险相似。
