Dangerous gout for middle-aged men, causes and how to manage

Causes of the occurrence of gout

The food we eat contains substances called purines*, which are essential for survival. After purines are used by the body, they leave behind a residue called uric acid. Gout can occur when too much uric acid is consumed, when uric acid is produced in the body, or when it cannot be excreted in the urine or feces.

*Purines: These are nitrogenous compounds, which are converted into uric acid when broken down in the body.

Gout is more common in men who enjoy drinking. This is because meat snacks eaten with alcohol contain a lot of purines, while men have more muscle and cell mass than women, so the production of basic uric acid is higher, and there are no female hormones that inhibit the reabsorption of uric acid in the kidneys.

Gout is predominantly seen in middle-aged men, but in recent years, the number of young men has also been increasing. Lee Sang-hoon, a professor of rheumatology at Kyung Hee University Hospital in Gangdong, explains that the main reason for this is Westernized eating habits.

Dangers of gout

Gout can lead to recurrence of arthritis attacks and puts you at risk for serious complications. According to the 'Diagnosis and Treatment Survey of Gout Patients in Korea' published in the Journal of the Korean Society of Rheumatology, gout is often accompanied by chronic metabolic diseases such as hypertension and diabetes. A study of 136 patients treated for gout at three university hospitals between 2005 and 2008 found that 36% had hypertension, 11% diabetes, 8.1% angina, 6.6% heart failure, and 4.4% hyperlipidemia.

In fact, half of gout patients have high blood pressure and metabolic syndrome, and 1 in 10 have diabetes. Conversely, about 1 in 4 untreated hypertensive patients have hyperuricemia, a uric acid level of 7 mg/dL or higher in the blood. As you can see, gout is not just a treatment for arthritis, but it is also very important to check for complications.

Gout is more dangerous for people with kidney disease

Kidney disease and hyperuricemia are closely related. Uric acid is excreted primarily by the kidneys, as hyperuricemia causes the kidneys to excrete more uric acid, which can lead to kidney failure. Conversely, kidney failure can also cause hyperuricemia, which can lead to gout.

Treatment of arthritis caused by gout in patients with kidney failure is also limited because the anti-inflammatory drugs given reduce kidney function. The safest drugs to be used to treat acute gouty arthritis in patients with renal failure are steroids, both oral and intra-articular injections.

Advice for treating gout

The key to gout is to manage the uric acid that causes it. Therefore, it is necessary to avoid factors that can increase blood metabolism on a regular basis. In particular, alcohol increases uric acid in the blood by inhibiting the excretion of uric acid directly from the kidneys, so drinking should be reduced.

In the long term, uric acid levels can be managed with consistent medication and lifestyle modifications, which can help maintain a normal lifestyle. If you have frequent arthritis despite medication, or if your blood acids are not going down well, it is recommended to limit foods high in purines. Foods high in purines include offal such as heart and liver, gravy, goose, sardines, mackerel, anchovies, yeast, and bacon.

In addition, it is necessary to check for obesity, hyperlipidemia, diabetes, hypertension, etc., which may be associated with hyperuricemia, and to treat them together