Using data from the National Health and Nutrition Examination Survey (NHANES) 2007-2008, researchers have shown that the prevalence of gout in the United States has increased to 3.9% (8.3 million Americans) compared with 2.7% in NHANES-III, which covered the period of 1988-1994. Additionally, the prevalence of hyperuricemia was 21.4%, or about 43.3 million individuals, and significantly higher than in NHAMES III, with an unadjusted difference of 3.2%.
The study, which included 5,707 participants and was published in Arthritis & Rheumatism, noted that the NHANES surveys combined interviews, physical examinations, and various laboratory data to reach conclusions about the prevalence of diseases in this time period.1 The 1988-1994 study period included 18,825 patients.
The article indicated that the prevalence of gout was highest in men and seniors at 5.9% and 9.8%, respectively. For women, it was 2%. Hyperuricemia, on the other hand, was nearly equal in the sexes: 21.2% among men and 21.6% among women. The prevalence increased with age, up to 31.4% in people ages 65 years or older.
H. Ralph Schumacher, Jr., MD, professor of medicine at the University of Pennsylvania in Philadelphia, who is not associated with the research, says that the study “addressed prevalence, not incidence, and actually suggested very little increase in the last 20 years.”
Dr. Schumacher also says that the study indicates the data were based on a telephone report “and that a doctor told them they had gout. So, estimates [of gout cases made in the research] may be high, but gout is certainly still a problem.” He adds that, “they considered a lower level of SUA [serum uric acid] as hyperuricemic in women.”
The authors of the study commented that, “according to the data gathered [in NHANES-III], the disease burden of gout was already substantial and increasing worldwide… Western diets, sedentary lifestyle, an increased frequency of obesity and hypertension, and increased use of diuretics and aspirin have been suspected to contribute to the increase before the new millennium,” with the same causes suspected in the newer survey.
They added that the substantial prevalence of both gout and hyperuricemia “has been sustained during the last two decades and indeed may still be increasing.”
The authors suggested that, “modifiable risk factors for gout and hyperuricemia include lifestyle and dietary factors (obesity, alcohol, fructose, purine-rich fatty food), certain drugs (thiazide and loop diuretics), and disease conditions (hypertension, renal insufficiency, and heart failure).” Additionally, “heavy drinking should be avoided.”
Sue Pondrom is a medical journalist based in San Diego.
Reference
1. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: The National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum. 2011;63:3136-3141.
