Gout has traditionally been thought of as a disease of older men, but olderwomen get it, too. A recent national health survey found that about 4% of womenin their 60s and 6% of those in their 80s had gout.
In one of the first large studies to examine gout by gender, researchersfound that in women, just as in men, older age, obesity, high blood pressure,alcohol use, and use of diuretics are all risk factors for gout.
Gout occurs when elevated blood levels of uric acid form crystals in thejoints and surrounding tissue, leading to excruciatingly painful inflammationand swelling.
The big toe, knee, and ankle joints are the most common sites for gout, andattacks frequently start during the night. The painful swelling typically goesaway in a few days, but more than half of people who have one attack will haveothers.
Older Age, Weight Raise Gout Risk
In an effort to better understand the impact of gender on gout, researchersfrom Boston University School of Medicine examined data on 2,476 female and1,951 male participants in the ongoing Framingham Heart Study, which hasfollowed residents of Framingham, Mass., since the late 1940s.
Over an average of three decades of follow-up, 304 cases of gout werereported, with one-third of those cases occurring in women.
For both sexes, gout incidence rose with increasing uric acid levels. Butthe association was stronger for men than for women.
Women with serum uric acid levels over 5 milligrams/deciliter had asignificantly lower risk of developing gout than men with identical uric acidlevels.
Other gender differences identified by the researcher include:
- A higher proportion of women than men had high blood pressure and werebeing treated with diuretics. This finding suggests these two risk factors maybe more important for women than men, the researchers say.
- Drinking 7 or more ounces of spirits a week — roughly five drinks –doubled the gout risk in men and tripled it in women. Heavy beer drinking wasassociated with a doubling of risk among men and a sevenfold increase in riskamong women.
Beer contains high levels of the chemical purine, which breaks down intouric acid in the body. But it is not clear why beer drinking would pose ahigher gout risk for women than for men.
Obesity was associated with a roughly threefold greater risk for gout amongboth men and women in the study.
Finally, taking estrogen as hormone therapy appeared to lower gout risk inwomen, but the link was not statistically significant.
Estrogen is believed to lower uric acid levels in the blood, and previousstudies have shown hormone therapy can protect against gout, studyresearcher Hyon Choi, MD, tells WebMD.
Gout Risk and Diet
Many people associate gout with eating large amounts of meat — especiallyorgan meats, which contain high levels of purine.
But diet was not among the major risk factors identified in the study.
Rheumatologist Patience White, MD, tells WebMD that women and men who wantto avoid gout need to watch their weight, blood pressure, and alcoholconsumption.
White is chief public health officer for the Arthritis Foundation and aprofessor of medicine and pediatrics at George Washington University inWashington, D.C.
“Diet plays a role, but it is a drop in the bucket,” she says.
She says that more and more women are likely to get gout as the populationages. “Women need to understand that their gout risk goes up aftermenopause.”
White adds that at the population level, women are heavier than they haveever been and they are drinking more alcohol.