Abstract. Arterial hypertension (AH) is one of the most common diseases of the circulatory system in Ukraine, Europe, and worldwide. AH is often associated with gout.

The aim of the study was to assess the characteristics of AH progression in the presence of gout.

Materials and methods. A total of 62 patients with AH were examined and divided into two groups. Group I included 20 patients with AH without comorbidities; Group II comprised 42 patients with AH combined with gout. A control group consisted of 20 practically healthy individuals. All patients underwent anthropometric, general clinical, laboratory, and instrumental examinations, including electrocardiography, echocardiography, and ultrasonography of internal organs and joints affected by gout.

Results. The most common complaints in both groups were recurrent headache attacks, reported by 92.2 % of patients in the comorbid group and 90.0 % in the isolated AH group. Patients with combined pathology showed a significant increase in body weight, BMI and waist-to-hip ratio. This group also demonstrated elevated levels of proatherogenic lipid fractions: total cholesterol was increased in 29 (90.6 %) patients, LDL in 23 (71.8 %), and triglycerides in 17 (53.1 %).

Patients with AH and gout had significantly higher levels of creatinine (+24.7 %), urea (+73.7 %), and AST (+37.1 %) (p < 0.01). The IL-6 level in the AH + gout group was 2.76 times higher than in the isolated AH group (p < 0.05), and CRP was elevated by 2.19 times, respectively. GFR was significantly lower in this group (by 12 %; p < 0.01).

Echocardiographic findings revealed that enlargement of the left atrium was more common in patients with AH and gout, indicating potential development of left ventricular diastolic dysfunction.

Conclusions. In patients with arterial hypertension (AH) combined with gout, significantly higher values of body weight and body mass index were observed, indicating a higher prevalence of overweight and an increased cardiovascular risk.

The comorbid condition was associated with more pronounced metabolic disturbances, particularly hyperuricemia, dyslipidemia, elevated levels of triglycerides, total cholesterol, and low-density lipoprotein cholesterol (LDL-C), as well as decreased levels of high-density lipoprotein cholesterol (HDL-C). Patients with both AH and gout more frequently exhibited impaired renal function (elevated levels of creatinine and urea, decreased glomerular filtration rate) and signs of systemic inflammation (increased levels of C-reactive protein and interleukin-6), indicating the damaging effect of this disease combination on the kidneys and an enhanced immune response.

Echocardiographic examination revealed more pronounced cardiac remodeling in patients with the combined pathology, manifested by enlargement of the left atrium, right ventricle, and ascending aorta, which reflects more frequent target organ damage, primarily of the heart, in these patients.

Gout is a factor that worsens the course of arterial hypertension and requires a comprehensive treatment approach, taking into account the risks of metabolic, renal, and cardiovascular complications.

Ключові слова: arterial hypertension, gout, metabolic syndrome, hyperuricemia

Повний текст: PDF (Ukr)

1. Zuin M, Tognola C, Maloberti A, et al. Advances in Hypertension Management: Insights from the Latest European Guidelines. J Cardiovasc Dev Dis. 2025 Apr 14;12(4):155.doi.org/10.3390/jcdd12040155
2. Gallo G, Savoia C. Hypertension and Heart Failure: From Pathophysiology to Treatment. Int J Mol Sci. 2024 Jun 17;25(12):6661.doi.org/10.3390/ijms25126661
3. Mishchenko LA, Kolesnik TV, Khomazyuk TA, et al. May Measurement Month 2017-2019: an analysis of blood pressure screening results from Ukraine. Eur Heart J Suppl. 2022 Oct 7;24(Suppl F):F41-F44.doi.org/10.1093/eurheartjsupp/suac035
4. Das D, Shruthi NR, Banerjee A, et al. Endothelial dysfunction, platelet hyperactivity, hypertension, and the metabolic syndrome: molecular insights and combating strategies. Front Nutr. 2023 Aug 8;10:1221438.doi.org/10.3389/fnut.2023.1221438
5. Zhdan VМ, Lebid' VG, Кhaimenova HS, Isheikina GA. Gout and Arterial Hypertension:Therapy Peculiarities. Actual Problems of the Modern Medicine: Bulletin of Ukrainian Medical Stomatological Academy. 2020;1(69):100-105).doi.org/10.31718/2077-1096.20.1.100
6. GBD 2021 Gout Collaborators. Global, regional, and national burden of gout, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2024 Aug;6(8):e507-e517.
7. Vatseba MO, Seredyuk NM, Vakaliuk IP. The influence of complex treatment on indicators of systemic immunoinflammatory activation in patients with gout with arterial hypertension and obesity. Terapevtyka. 2021;2(2):45-49).
8. Borghi C, Agabiti-Rosei E, Johnson RJ, Kielstein JT, Lurbe E, Mancia G, Redon J, Stack AG, Tsioufis KP. Hyperuricaemia and gout in cardiovascular, metabolic and kidney disease. Eur J Intern Med. 2020 Oct;80:1-11.doi.org/10.1016/j.ejim.2020.07.006
9. Kuzmina AP, Lazarenko OM. Arterial hypertension and gout: current state of the problem (literature review). Medical perspectives. 2017;22(4):19-24).doi.org/10.26641/2307-0404.2017.4.117662
10. De Becker B, Borghi C, Burnier M, van de Borne P. Uric acid and hypertension: a focused review and practical recommendations. J Hypertens. 2019 May;37(5):878-883.doi.org/10.1097/HJH.0000000000001980
11. Yuan J, Xie Z, Pan B, Zhang J. Impact of gout on cardiovascular disease mortality: a meta-analysis. Z Rheumatol. 2024 Dec;83 (Suppl 3):329-337.doi.org/10.1007/s00393-024-01479-x
12. Borghi C, Agnoletti D, Cicero AFG, Lurbe E, Virdis A. Uric Acid and Hypertension: a Review of Evidence and Future Perspectives for the Management of Cardiovascular Risk. Hypertension. 2022 Sep;79(9):1927-1936.doi.org/10.1161/HYPERTENSIONAHA.122.17956
13. Zhao P, Shi W, Shi Y, Xiong Y, Ding C, Song X, Qiu G, Li J, Zhou W, Yu C, Wang T, Zhu L, Cheng X, Bao H. Positive association between weight-adjusted-waist index and hyperuricemia in patients with hypertension: The China H-type hypertension registry study. Front Endocrinol (Lausanne). 2022 Oct 6;13:1007557.doi.org/10.3389/fendo.2022.1007557
14. Feig DI, Nakagawa T, Karumanchi SA, Oliver WJ, Kang DH, Finch J, Johnson RJ. Hypothesis: Uric acid, doi.org/10.1111/j.1523-1755.2004.00729.x
15. Du L, Zong Y, Li H, Wang Q, Xie L, Yang B, Pang Y, Zhang C, Zhong Z, Gao J. Hyperuricemia and its related diseases: mechanisms and advances in therapy. Signal Transduct Target Ther. 2024 Aug 28;9(1):212.doi.org/10.1038/s41392-024-01916-y