Weight reduction towards ideal body weight and moderation in ethanol consumption have each been convincingly shown to reduce both the risk of incident gout and the expression of established gout. Other comorbidities have also been the subject of study.
Hyperuricemia and gout are frequently accompanied by one or more major disorders, such as hypertension, obesity, diabetes, and hyperlipidemia, which are components of the metabolic syndrome or insulin resistance. cardiovascular disease; chronic renal functional impairment; and certain dietary factors such as high alcohol or purine intake. These associations have raised the question of whether lifestyle and pharmacologic strategies aimed at treatment of one or more of these comorbidities might suffice to reduce the risk of incident gout and/or the progression of gout. In addition, gout may contribute to adverse outcomes for some of these comorbidities. For example, observational data suggest that gout flares may be associated with a transient increase in cardiovascular events following a flare.
A number of studies support the benefit of weight loss. and of moderation in ethanol consumption. Each of these actions can reduce the risk of incident gout and the expression of established gout.
Thus, depending upon the comorbidities present, lifestyle modifications and pharmacologic management directed towards targets other than urate-lowering in gout patients might include:
●Management of common comorbid diseases
●Reduction to ideal body weight
●Changes in dietary composition
●Dietary supplementation, such as with cherries
●Reduction of alcohol intake
●Substitution, where possible, appropriate, and safe to do so, for medications and/or dietary additives that reduce urate excretion or increase urate production
