Posts Tagged “uric acid”

A recent gout forum post bemoaned the tantalizing finale to a sales pitch for an expensive article on uric acid and heart disease.

Our contributor wanted to scream for the conclusion of an article which ended (before you had to pay) with the teasing :

“risk for sudden cardiac death among patients with myocardial infarction who…”

I’m happy to provide more, for the usual price of free, but I cannot promise all the answers.

First, I should point out that the offending article was Read the rest of this entry »

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Uric Acid And Blood Pressure Medication

The link between uric acid and blood pressure medication is just one aspect of the relationship between gout and high blood pressure (hypertension).

In fact, hypertension, high blood pressure, or diuretic in the Gout Search Engine (at the foot of every page, and elsewhere throughout the site) will reveal a wealth of information.

You might know that diuretics prescribed for high blood pressure are a common cause of gout. This need not be so.

With the right approach, it is actually possible to lower uric acid with blood pressure medication.

Back in May,

zip2play said:

My research has shown one antihypertensive regimen that lowers uric acid.  I will repeat it here.

It involves the use of two antihypertensive drugs, furosemide and losartan, (Lasix and Cozaar) but they must be taken in a particular way: first take the Lasix (which causes brisk diuresis) and then several hours later, take the Cozaar which causes uric acid elimination. Dosage of both drugs is titrated to get reasonable blood pressure control. Needless to say, people with NORMAL BP should not use this regimen.

The study confirming this regimen is small but rather convincing, but studies showing the uricosuric effect of losartan are all over the net. It;s the ONLY antihypertensive with this capability but used alone its effect is not large.

The name of the study is “Effects of the uricosuric action by losartan on the patients taking furosemide”, and the results show clearly in the chart above.

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Do Not Be Ruled By Food
Thanks to chelseacharliwhite at Flickr.
Click on image for more details

Do Not Be Ruled By Food

It often worries me how gout sufferers get hung up on their diet.

I’m not worried that it’s wrong to think about what you eat – just don’t get obsessed.

Over half of the messages I receive are about food and drink.

“What food should I eat with gout?”

“What food should I avoid with gout?”

“Will [food] make my gout worse?”

The gout sufferer’s diet questions are endless, and the gout doctor’s diet advice is monotonous.

No Alcohol. Avoid purines. Lose weight.

Not particularly bad advice, but too general to be helpful, and too restrictive to be accepted.

The real danger here is that gout patients focus on food, and not on what really matters – controlling uric acid.

It’s heartening to see that some doctors are realizing that strict low purine diets are not the right way. “In treating gout, don’t overdo diet restrictions” is a refreshing article from Dr Robert Shmerling. He does not…

recommend strict dietary modifications after an initial attack of gout.

Like me, he points out the research showing weaknesses in strict low purine diets. Significantly he continues:

these studies looked at people who had not had gout before. They did not assess the effect of diet on people who already had gout.

In a nutshell, you need to stop obsessing about specific foods. Eat a healthy varied diet that satisfies you. Enjoy what you eat, but just eat enough to maintain a healthy weight, and exercise as often as you can.

Drastic changes simply do not work, and some can make your gout worse. Small improvements every few days soon make a big difference. Most importantly, you feel better because you’re in control.

To feel even more in control, learn more about gout. When you understand how gout pain is caused, and why uric acid control is so important, you are much better placed to help yourself, and ask the right questions of your doctor.

Your added bonus is that, when you are learning about gout, it helps you to stop worrying about food.

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