GOUT AND RISK FOR SUBSEQUENT CORONARY HEART-DISEASE - THE MEHARRY-HOPKINS STUDY

Background: Patients with gout are encountered frequently in clinical practice. Previous studies have suggested that hyperuricemia and gout ma) represent risk factors for coronary heart disease (CHD), the most common cause of death in American men. Methods: Prospectively collecte d data from 2 longitudinal cohort studies of former medical students-3 71 black men in the Meharry Cohort Study and 1181 white men in the Joh ns Hopkins Precursors Study-were analyzed. The development of gout and of CHD was determined by physician self-report, and validated by usin g published criteria. The risk for CHD associated with gout was evalua ted using Cox proportional hazards analysis. Results: During a median follow-up of 30 years, there were 38 gout cases and 43 CHD events amon g the Meharry men, and 68 gout cases and 138 CHD events among the Hopk ins men. Prior gout was not associated with an increased risk for inci dent CI-ID (relative risk=1.20; 95% confidence interval, 0.37-3.92) am ong the Meharry men or among the Hopkins men (relative risk=0.66; 95% confidence interval. 0.24-1.79). Multivariate analysis adjusted for kn own CHD risk factors did not alter these findings. Conclusion: These r esults, in black and white male physicians, do not suggest a role in m en for targeting gout identification in the primary prevention of CHD.