The impact of lifestyle on cardiovascular risk in patients with gout: a population-based cohort study

Abstract Aims Gout is associated with a significant burden of cardiovascular disease. The aim of this study was to evaluate the impact of a favourable lifestyle on incident cardiovascular events in patients with gout. Methods We identified 9 110 patients with gout from the UK Biobank cohort based on self-report and/or hospital diagnostic codes. Lifestyle behaviours, including smoking status, physical activity, obesity, and diet, were categorized into three patterns: favourable (three to four healthy factors), intermediate (two healthy factors), and unfavourable (zero to one healthy factor). The cardiovascular risk of participants with and without gout was estimated based on their serum uric acid levels and lifestyle patterns. Results Among 9 110 patients with gout and 457 596 participants without gout, the median follow-up duration was 8.9 years. The incidence rate of cardiovascular disease was significantly higher in the gout population than in the non-gout population (11.38 vs. 5.49 per 1000 person-years). The gout population consistently exhibited a high cardiovascular risk, irrespective of uric acid levels, whereas a positive correlation was observed between uric acid levels and cardiovascular risk in the non-gout population. Adopting a favourable lifestyle pattern was associated with a lower risk of cardiovascular disease in both gout and non-gout populations. Across all categories of uric acid, a favourable lifestyle was found to reduce cardiovascular risk in patients with gout. Conclusion Patients with gout remain at high risk of developing cardiovascular disease despite having normal uric acid levels. Lifestyle modifications may represent an effective and cost-efficient therapeutic approach for preventing cardiovascular events in this population.