J Rheum Dis.  2023 Jul;30(3):185-197. 10.4078/jrd.2023.0011.

Regional variations of cardiovascular risk in gout patients: a nationwide cohort study in Korea

• Kim HJ
• Ghang B
• Kim J
• Ahn HS

• KMID: 2543945
• DOI: http://doi.org/10.4078/jrd.2023.0011

Abstract

Objective
The extent of regional variations in cardiovascular risk and associated risk factors in patients with gout in South Korea remains unclear. Therefore, we aimed to investigate the risk of major cardiovascular events in gout patients in different regions.
Methods
This was a nationwide cohort study based on the claims database of the Korean National Health Insurance and the National Health Screening Program. Patients aged 20 to 90 years newly diagnosed with gout after January 2012 were included. After cardiovascular risk profiles before gout diagnosis were adjusted, the relative risks of incident cardiovascular events (myocardial infarction, cerebral infarction, and cerebral hemorrhage) in gout patients in different regions were assessed.
Results
In total, 231,668 patients with gout were studied. Regional differences in cardiovascular risk profiles before the diagnosis were observed. Multivariable analysis showed that patients with gout in Jeolla/Gwangju had a significantly high risk of myocardial infarction (adjusted hazard ratio [aHR], 1.27; 95% confidence interval [CI], 1.02~1.56; p=0.03). In addition, patients with gout in Gangwon (aHR, 1.38; 95% CI, 1.09~1.74; p<0.01), Jeolla/Gwangju (aHR, 1.41; 95% CI, 1.19~1.67; p<0.01), and Gyeongsang/ Busan/Daegu/Ulsan (aHR, 1.37; 95% CI, 1.19~1.59; p<0.01) had a significantly high risk of cerebral infarction.
Conclusion
We found there were regional differences in cardiovascular risk and associated risk factors in gout patients. Physicians should screen gout patients for cardiovascular risk profiles in order to facilitate prompt diagnosis and treatment.

Keyword

Regional medical programs; Gout; Cardiovascular diseases

Figure

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  Fig. 1 Forest plot of the risk of myocardial infarction (A), cerebral infarction (B), and cerebral hemorrhage (C). BP: blood pressure, DBP: diastolic blood pressure, HDL: High-density lipoprotein cholesterol, LDL: low-density lipoprotein cholesterol, SBP: systolic blood pressure, TG: triglyceride.

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