Division of Rheumatology, University of Connecticut Health Center, Meriden.
Crystal Diseases Study Group, Division of Rheumatology, New York University School of Medicine, New York, USA.
Curr Opin Rheumatol. 2019 Mar;31(2):118-124. doi: 10.1097/BOR.0000000000000585.
Gout is associated with the risk of cardiovascular morbidity and mortality, but the biological relationship between the two remains uncertain. The demonstration of reduction of cardiovascular risk with appropriate gout treatment would argue for a causal role for gout in cardiovascular disease. We reviewed recent studies that address the relationship between gout and cardiovascular disease.
Studies are conflicting; some show that lowering serum uric acid levels leads to better cardiovascular outcomes, whereas others show no such benefit. Inconsistencies in study design may contribute to these variations in outcome. Additionally, different gout treatment strategies may affect cardiovascular outcomes differently.
Despite an abundance of data generated in the last 5 years, it remains unclear whether treating gout with urate-lowering therapy provides a cardiovascular benefit. Additionally, further studies are needed to clarify whether different urate-lowering drugs confer different cardiovascular risks or benefits. Nonurate-lowering agents used for gout or commonly used in gout patients, such as colchicine and statins, may also improve cardiovascular outcomes in this population.
痛风与心血管发病率和死亡率相关，但两者之间的生物学关系尚不确定。如果适当的痛风治疗能降低心血管风险，则说明痛风在心血管疾病中起因果作用。我们综述了最近探讨痛风与心血管疾病之间关系的研究。
研究结果相互矛盾；一些研究表明降低血清尿酸水平可改善心血管结局，而另一些研究则未显示出这种益处。研究设计的不一致可能导致了这些结果的差异。此外，不同的痛风治疗策略可能会对心血管结局产生不同的影响。
尽管在过去 5 年中产生了大量的数据，但仍不清楚用降低尿酸的疗法治疗痛风是否能带来心血管益处。此外，还需要进一步的研究来阐明不同的降尿酸药物是否会带来不同的心血管风险或益处。用于痛风或痛风患者常用的非降尿酸药物，如秋水仙碱和他汀类药物，也可能改善该人群的心血管结局。
