Two blood pressure medications can cause sharp crystals to coalesce in joints – risk of gout attack

Arthritis describes a wide range of inflammatory conditions, some more painful than others. In gout, excess uric acid in the body turns into sharp crystals that accumulate and cause inflammation in the joints. Pain and swelling are common symptoms, but as attacks get worse, the condition can become increasingly debilitating.

The Cleveland Clinic explains, “Gout is a type of arthritis that occurs when excess uric acid in the body forms crystals in the joints. The crystals cause pain and swelling.”

Some common risk factors for the conditions include being overweight, having diabetes, or having high blood pressure.

Although beneficial for blood pressure, some medications can also cause sharp crystals to form in the joints.

According to the Mayo Clinic, this is why some diuretics “increase the risk of developing gout.”

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The Health Authority adds: “This can happen because diuretics increase urination, which reduces the amount of fluid in your body.”

Hyperuricemia, a major contributing factor to gout attacks, is common in people receiving treatment.

The body produces uric acid when it breaks down purines, compounds found in various foods.

Although the exact mechanisms of hyperuricemia during diuretic treatment have not yet been elucidated, some hypotheses have been put forward.


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In 2006, a researcher writing in the Annals of Rheumatic Diseases suggested that diuretics may cause hyperuricemia by increasing the reabsorption of waste-generated uric acid.

As soon as there is an excess of rice acid in the body, the crystals accumulate in the joints, fluids and tissues of the body.

However, it should be noted that not all people with high uric acid levels experience gout symptoms or need treatment.

“Many people with hyperuricemia never develop gout, and even when they do, they often have high blood uric acid levels for years without any symptoms,” explains Harvard Health.

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The two diuretics that carry the greatest risk of gout are thiazide and loop diuretics due to changes in serum urate, according to researchers writing in the journal Arthritis and Rheumatology.

The scientists noted, “While hypertension is the primary indication for diuretic use, it is also an independent risk factor for gout.”

This makes it difficult for studies to differentiate whether diuretic use is the cause of gout or the underlying cause of hypertension.

For this study, studies of patients with hypertension that can control blood pressure changes with treatment may be more appropriate to quantify the association between diuretics and gout risk.

What are the symptoms of gout?

When gout symptoms appear, they appear suddenly and usually affect one joint first.

“Within a few hours, this joint becomes red, swollen, hot, and painful,” explains Harvard Health.

The joint at the base of the big toe is a common site for gout attacks, but the knees and ankles are also commonly affected.

Patients with higher blood uric acid levels can be taught to make lifestyle changes, but there are several treatments that can control blood uric acid levels.

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