Treating Gout with Drugs Benefits Heart Health

Gout is a common inflammatory disease that is just now starting to get the attention it deserves. Roughly 4% of adult Americans suffer from gout attacks, at least from time to time, Scientists believe it results from excessive urate (aka uric acid) in the body. When the kidneys can’t keep up with filtering out the urate, it builds up and can precipitate into the joints. This creates an extremely painful crisis that has been described as feeling like the joints are full of broken glass. While most of the attention has been on how to alleviate that excruciating pain, gout is a systemic condition. New research demonstrates that treating gout adequately can reduce the risk of cardiovascular complications, which are common in people with gout (JAMA Internal Medicine, Jan. 26, 2026).

Treating Gout and Lowering Urate Helps the Heart:

The researchers evaluated over 100,000 medical records in England that had been shared with the Clinical Practice Research Datalink. They date from 2007 to 2021 and include data on urate levels, drug treatments and hospitalization and death. To simulate a clinical trial, the investigators compared people whose urate levels were below 6 mg/dL after a year of treatment to those whose urate levels were higher than 6 mg/dL. The was set as the target in Europe about two decades ago.

According to the scientists, the analysis shows that people whose gout treatment brought their urate level below 6 mg/dL were slightly less likely to suffer a heart attack or stroke or to die from cardiovascular causes. The difference was about 9%, which was statistically significant. The doctors treating gout in their patients prescribed allopurinol to nearly all of them. Patients whose initial risk of cardiovascular problems was especially high got the most benefit from effective treatment. Those whose urate levels dropped below 5 mg/dL also got better cardiovascular protection.

Previous Research on Treating Gout with Allopurinol:

More than 15 years ago, we reported on research indicating that allopurinol, a very old drug used to prevent gout, had impressive power to protect the heart (The Lancet, June 8, 2010). Allopurinol, also sold under the brand name Zyloprim, has been used for more than five decades to lower uric acid levels in the blood.

Allopurinol was tested in a placebo-controlled trial to see how well it protects the heart from exercise-induced angina. Subjects suffered from chronic chest pain. They were given either allopurinol or a placebo pill and were put on a treadmill. Those taking allopurinol walked 25 percent longer than those on placebo. The Scottish investigators point out that allopurinol has a good safety record and is also very inexpensive.

What Should You Know About Allopurinol and Heart Disease?

Despite the researchers’ reassurance about its safety record, allopurinol occasionally causes some serious reactions. People who have kidney or liver problems or who have had severe skin reactions should discuss this with their clinician. Still, it is apparent that allopurinol has benefits beyond simply easing joint pain. Probably everyone who has ever had a gout attack should be treating gout with allopurinol. Given the most recent research, they should aim to get urate below 6 mg/dL.

A subsequent study from Taiwan compared heart attack patients treating gout with urate lowering drugs to those not taking urate lowering medicine (Clinical Pharmacology and Therapeutics, March 2022). People taking allopurinol or another urate lower therapy were less likely to die during the decade of the study. In addition, they were less likely to have a repeat heart attack or to need a coronary artery bypass. These researchers believe that treating gout to reduce uric acid also lowers inflammation throughout the body.

Treating Gout to Prevent Heart Disease:

Another study from Taiwan analyzed the medical records of more than 4,000 patients with gout (Frontiers in Medicine, Feb. 27, 2020). Approximately half of these individuals were on urate lowering therapy, while the other half were not. The researchers found a small but significant difference between these two groups. Those on urate lowering therapy had less chance of developing coronary heart disease or suffering a stroke.

The investigators conclude:

“We recommend that patients with gout receive ULT to lower the burden of CV diseases.”

The People’s Pharmacy Take:

This website contains many stories of people who got relief from gout-related joint pain with home or herbal remedies such as celery seed, tart cherry juice, vitamin C or turmeric. Given the research indicating the benefits of urate lowering therapy, we suggest that such remedies be used in addition to rather than instead of drugs like allopurinol.