case report patient hypertension gout

Case 1: A 67-year-old man was referred to our hypertension clinic because of refractory hypertension associated with gout. The onset of hypertension occurred in his 20s. Since his early 30s, he also had recurrent podagra, and at that time was taken off thiazide, but nonetheless continued to experience recurrent gouty episodes every several months.

Full Answer

How common is hypertension in patients with gout?

According to the latest estimates from the US National Health and Nutrition Examination Survey (2007-8), 74% of patients with gout have hypertension,1which corresponds to 6.1 million adults in the United States alone.

Does the daily dose of antihypertensive medication affect gout risk?

Relative risk of gout associated with daily dose of antihypertensive agents among current users, stratified by presence of hypertension Daily dose Hypertension No hypertension No (%) of controls (n=16 280)

What is the clinical presentation of a gout attack?

Clinical Presentation Gout attacks are usually associated with precipitated events. Patients usually present with rapid onset of severe pain, swelling, redness, and warmth in one or tow joints. This pain and inflammation are caused by inflammatory response.

How valid are doctors’ diagnoses of gout?

Furthermore, when we used doctors’ diagnoses of gout combined with anti-gout drug use (which showed a validity of 90%2122) as our case definition, our results remained almost identical.

What is gout in men?

Gout is an inflammatory disease characterized by the deposition of uric acid crystals in and around joints, subcutaneous tissues, and kidneys. Although men and women are equally affected by gout, men are six times more likely to have serum concentrations above 7 mg per dL.

How long does gout last?

This pain and inflammation are caused by inflammatory response. Acute attack untreated attacks usually last two to 21 days depending on cases. There are four clinical stages of gout according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).

What is the second stage of gout?

This second stage is known as acute gouty arthritis. The third stage, known as interval or intercritical gout, involves the interval between acute flare gout attacks with persist crystals in the joints. When crystals deposits continue to accumulate, patients are likely to develop chronically stiff and swollen joints.

When does gout occur?

Gout typically occurs during middle age and is uncommon before the age 30 years old. Women rarely have gouty arthritis attacks before menopause 1. Gout attacks are usually associated with precipitated events. Patients usually present with rapid onset of severe pain, swelling, redness, and warmth in one or tow joints.

What are the three main objectives of FNP?

The three main objectives that FNP take into consideration are treatment for the acute attacks, prophylaxis against recurrent attacks, and management of hyperurecemia. Asymptomatic hyperurecemia: urate-lowering drugs is not recommended to treat patients with asymptomatic hyperurecemia.

Does gout run in families?

Primary gout runs in families and follows multifactorial inheritance. The expanded use of agents that decrease uric acid excretion has significantly increased the incidence of secondary gout. The Fremingham Study suggested that almost half of new cases were associated with thiazide use.

Is triamcinolone acetonide a contraindication to NSAIDs?

Triamcinolone acetonide is especially useful in patients with contraindication to NSAIDs. Oral prednisone: is an option when repeat dosing is anticipate. Prenisone, 0.5 mg per kg on day 1 and tapered by 5 mg each day is effective. Cochicine is also effective treatment for acute gout.