Background/Purpose: Many studies have reported that gout and hyperuricemia are associated with an increase in all-cause mortality and cardiovascular mortality.Increased vascular stiffness is closely related to the occurrence of cardiovascular disease. Many studies have shown a significant correlation between uric acid levels and arterial stiffness. However, there is no study on whether vascular stiffness is improved by uric acid-lowering treatment in gout patients. Few studies have reported that uric acid-lowering treatment reduces vascular stiffness in chronic kidney disease patients. The aim of this study is to evaluate the effect of uric acid lowering treatment on vascular stiffness in gout patients.

Methods: Between June 2017 and June 2019, patients who visited Jeju National University Hospital for treatment of gout were measured for augmentation index (AIx) and follow-up to evaluate changes in vascular stiffness by uric acid lowering treatment.

Results: One hundred twenty patients participated in the study and AI was measured. At the time of the enrollment, the average age of patients was 55.1 ± 12.9 years, the mean duration of gout was 7.0 ± 6.4 years, the mean duration of uric acid lowering treatment was 27.8 ± 34.0 months, the average of uric acid level was 5.8 ± 1.9, the average of initial AIx was 22.5 ± 10.1 and the average of follow-up duration of AIx was 19.1 ± 2.1 months. When compared with the AIx improved and non-improved groups, there was a higher percentage of smokers in the improved group (16.7% vs 45.5%, p=0.007), and there was no significant difference in age, duration, and uric acid value between the two groups. However, in the group with improved AIx, the initial AIx level was significantly higher (20.6 ± 7.6 vs 26.9 ± 7.2, p< 0.001) and more people (63.6% vs 40.5%, p=0.046) had higher AIx than predicted AIx. When multivariate logistic regression analysis was performed, disease duration (b=0.714, 95% CI 0.528-0.965, p=0.029), ULT duration (b=1.059, 95% CI 1.003-1.118), smoking (109.972, 95% CI 3.693-3274.940, p=0.007) are predictor of improvement of vascular stiffness.

Conclusion: Our results show that long-term uric acid lowering treatment in patients with long gout disease duration can improve vascular stiffness.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/effects-of-uric-acid-lowering-treatment-on-vascular-stiffness-in-gout-patients/